Australia has one of the highest rates of colorectal cancer (CRC) globally, with approximately 1 in 13 Australians expected to develop the disease in their lifetime. It remains the second leading cause of cancer-related deaths, making early detection and prevention crucial.

Despite the availability of the National Bowel Cancer Screening Program (NBCSP), participation rates remain low at around 41%, and many cases are diagnosed at later stages when treatment options are more limited. However, recent breakthroughs in early detection, screening innovations, and dietary prevention strategies are shifting the landscape of CRC diagnosis and treatment.

The Growing Concern: CRC in Younger Australians

While CRC has traditionally been considered a disease of older adults, a rising trend of early-onset cases among younger Australians is prompting new concerns. Since 2000, the proportion of CRC diagnoses in people under 40 has tripled, increasing from 2.2% to 6.5% in 2024 (AIHW). This surge has led to calls for earlier screening and greater awareness among younger populations.

The #Never2Young Campaign

Recognising this alarming rise in early-onset CRC, Bowel Cancer Australia’s #Never2Young campaign aims to educate younger Australians on the risks, symptoms, and importance of early detection. The initiative challenges the misconception that bowel cancer is only an older person’s disease and advocates for earlier screening and improved clinical guidelines (Bowel Cancer Australia).

Breakthroughs in Early Detection: Blood-Based Screening Tests

One of the most promising advancements in CRC detection is the development of blood-based screening tests. Associate Professor Leah Cosgrove and her team are at the forefront of this innovation, working on a blood test that identifies CRC biomarkers with high accuracy.

Why This is a Game-Changer

✅ More Accessible – A simple blood test is far easier than the traditional stool-based iFOBT, which may encourage more Australians to participate in screening.
✅ Higher Sensitivity for Early Stages – This test aims to detect CRC before symptoms appear, improving survival rates.
✅ Better Screening for Reluctant Populations – Ideal for those who avoid traditional stool-based tests due to discomfort or mobility issues.

Early trials suggest that this blood test could revolutionise CRC screening by identifying cases at a treatable stage and reducing mortality rates (MJA).

National Bowel Cancer Screening Program (NBCSP) Developments (2018-2023)

The NBCSP has played a significant role in reducing CRC mortality, with recent research showing that participants had a 15-80% lower mortality rate compared to non-participants. However, participation rates remain low at around 41%, limiting its full impact (AIHW).

Key Updates from Recent Research:
  • Cost-Effectiveness of iFOBT Confirmed – Studies reinforce that the immunochemical faecal occult blood test (iFOBT) is the most cost-effective CRC screening tool.
  • Should Screening Begin at 45? – Research suggests screening from 45 years could further reduce CRC cases, though this would require increased resources.
  • Participation Strategies Show Promise – Advance notification letters and primary care involvement are being tested to improve screening rates.
  • More People Screening Privately – A significant portion of CRC screening happens outside the NBCSP, highlighting the need for better tracking and integration.

The Role of Diet in Colorectal Cancer Prevention

While screening is vital, prevention remains a cornerstone in the fight against CRC. Australian researchers from the Bowel Cancer Biomarker Research Group are investigating how diet impacts CRC risk, and findings continue to reinforce the importance of gut health and nutrition.

Key Dietary Findings:

✔️ High-Fibre Diets Reduce Risk – Whole grains, fruits, and vegetables (particularly those foods high in prebiotic and soluble fibres) support the gut microbiome, gut immune system and inflammation.
✔️ Dairy Consumption May Lower Risk – A recent study found that drinking one extra glass of milk per day could reduce CRC risk by 17% due to calcium and vitamin D
✔️ Polyphenols & Omega-3s Offer Protection – Found in berries, green tea, dark chocolate, and fatty fish, these compounds reduce oxidative stress and inflammation, both linked to CRC.

Foods That Increase CRC Risk 

❌ Red & Processed Meats – Cooking and processing methods produce carcinogenic compounds that increase CRC risk.
❌ Ultra-Processed Foods – High in additives, preservatives, and refined sugars, these can disrupt gut bacteria and increase inflammation.

Emerging research also highlights the gut microbiome’s role in CRC risk—meaning that what we eat can influence cancer risk. Precision nutrition strategies targeting gut microbiome balance could become a future tool for CRC prevention.

The Future of CRC Prevention & Treatment in Australia

  • Blood-Based Screening in NBCSP? – The potential integration of blood tests could increase participation rates and improve early detection.
  • Personalised Nutrition & Gut Microbiome Testing – As research advances, we may see tailored dietary guidelines based on an individual’s gut microbiome.
  • AI in Colonoscopy – Artificial Intelligence is being tested to enhance polyp detection, reducing missed cancers and improving accuracy.

Final Thoughts

Colorectal cancer remains a major health challenge in Australia, but breakthroughs in screening, public awareness, and dietary strategies offer new hope for prevention and early detection. Public health initiatives like #Never2Young play a crucial role in raising awareness, while new research on blood-based screening and dietary interventions shows promising potential for improving survival rates and long-term prevention.

The key takeaway? Get screened, prioritise gut health, and take action early.

– Check out the Bowel Cancer Australia website for more information –