Key recommendations to improve equity and access in colorectal cancer screening for rural and remote communities. A...

To explore barriers contributing to low participation in bowel cancer screening among rural populations, while investigating community-identified recommendations to improve access.

A grounded theory approach was applied to qualitative, online, semi structured interviews. Empirical data were inductively coded with constant comparison applied across the data corpus to contextualise meaning.

31 rural and remote Queenslanders participated. Theory surrounding the phenomena of low participation in bowel cancer screening highlighted broader system-level design-inhibited participation for geographically diverse populations. Pervasive themes prohibiting bowel cancer screening access stemmed from a lack of local healthcare availability across both primary care and endoscopic outpatient services as necessitated for community engagement and participation in bowel cancer screening.

This study highlights that access to both immunochemical faecal occult blood test (iFOBT) and follow-up colonoscopy is fraught with barriers preventing equitable access to bowel cancer screening for rural and remote communities. Consumer-driven patient navigation strategies, improved healthcare availability and adjustments to the current program design are required to mitigate program disparities.

Elevating the voices of lived-experience experts to influence existing models of delivery has the potential to increase participation in the National Bowel Cancer Screening Program and improve health outcomes for geographically diverse populations.