Prefer another language at home? The free bowel cancer screening kit comes back less often

Every two years, Australians aged 50 to 74 find a free bowel cancer screening kit in the letterbox. The test is done at home and the samples go back in a reply paid envelope. Of the 6.4 million people invited in 2023 and 2024, 42 per cent took part. For people who prefer to speak a language other than English at home, the estimate for the same two years is lower, between 24.1 and 30.8 per cent.

The figures are from the Australian Institute of Health and Welfare (AIHW), whose 2026 monitoring report on the National Bowel Cancer Screening Program counts tests returned by 30 June 2025. For people who prefer English, the institute’s estimate is 44.4 to 47.3 per cent.

At 45 to 49 it works differently. People in that age group have been eligible since 1 July 2024, the AIHW reports, but their first kit comes only if they ask for it.

Two ranges that never meet

Both language figures are estimates. The AIHW applied the language mix recorded in the 2021 Census, by age and sex, to the total number of invitations, to estimate how many people in each group were invited. A note on its table says the rates “were estimated using 2021 Census proportions”.

The ranges come from one unknown in the Census: its “not stated” group. The institute ran the numbers both ways, once with that entire share added to English and once with all of it added to languages other than English. Each published range spans the two results.

Either way, the ranges never meet. Even the top of the estimate for people who prefer another language, 30.8 per cent, sits below the bottom of the English range, 44.4 per cent.

The report’s language page stops at that two-way split. It has no breakdown by individual language, so it gives no figure for Hindi, Punjabi, Tamil or any other Indian language. The estimates describe that whole group, everyone whose preferred home language is not English, rather than Indian Australians in particular.

The fridge and the 14-day clock

The test in the kit is an immunochemical faecal occult blood test, which the AIHW describes as non-invasive and able to detect “microscopic amounts of blood” in a sample from a bowel motion. The kit holds two toilet liners, two collection tubes, a ziplock bag and a reply paid envelope. Instructions from the Department of Health, Disability and Ageing ask for two tiny samples from two separate bowel motions and a completed participant details form. The samples, the instructions say, should be kept between 2°C and 8°C, ideally in the fridge, and not frozen, until they are posted. In hotter parts of Australia, the kits arrive in the cooler months.

The clock starts with the first sample. If more than 14 days pass before the laboratory receives it, another kit is sent and the participant is asked to do the test again. The result reaches the participant and their doctor within four weeks. The department also publishes translated program material, home test kit instructions among it, on a translations page at health.gov.au/nbcsp-translations.

At 45, the first kit has to be asked for

People aged 45 to 49 can request their first free kit through the webform or by calling 1800 627 701, the department says, and anyone aged 45 to 74 can also ask their doctor about getting one. The National Cancer Screening Register, which sends out the kits, lists the eligibility conditions on its request page: an age between 45 and 74, an Australian mailing address, and a green Medicare card or registration as a Department of Veterans’ Affairs customer.

After that first test, the kits come on their own. The register says the next one is mailed automatically every two years after the last screening test is completed. Between July 2024 and December 2025, the AIHW counted 236,421 kit requests from people aged 45 to 49, and 56.2 per cent of those kits were returned, though the institute warns that its outcome data for people who requested or returned a kit late in that period will be incomplete.

A second bowel cancer screening gap, after a positive result

Of the people who screened in 2024, 6 per cent had a positive result that called for further assessment. In the department’s words, “A positive result is not a cancer diagnosis.” It also says to see a doctor as soon as possible. Participants with a positive result are advised, the AIHW says, to discuss further assessment, “in most cases, a colonoscopy”, with their primary health-care practitioner. In 2024, one in 29 people assessed after a positive screen was diagnosed with a confirmed or suspected bowel cancer.

Citing 2011 Australian stage data, the institute reports five-year relative survival of 99 per cent for bowel cancer diagnosed at stage I, when it has not spread outside the bowel wall, and 13 per cent at stage IV, when it has spread to other organs.

This is where the second language gap appears. Screening positivity in 2024 was 5.6 per cent for people who prefer another language and 5.8 per cent for those who prefer English, which the AIHW calls “the same screening positivity rate”. What happened next differed. Of those with a positive result, 78.6 per cent of people who prefer another language went on to a diagnostic assessment, against 86.4 per cent of those who prefer English. For the first group, the median time from positive screen to assessment was 64 days; for the English group, 61. These are 2024 results followed up to 31 December 2025, and the AIHW cautions that the assessment figures rely on forms the program does not require to be returned, so the data may be incomplete.

By the AIHW’s account, the register knows a participant’s preferred language only if they choose to give it when they return a completed details form. Everyone else, it assumes, speaks English.