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ObjectivesTo generate contemporary age-specific mortality rates for Indigenous and non-Indigenous Australians aged <65 years who died from rheumatic heart disease (RHD) between 2013 and 2017, and to ascertain the underlying causes of death (COD) of a prevalent RHD cohort aged <65 years who died during the same period.MethodsFor this retrospective, cross-sectional epidemiological study, Australian RHD deaths for 2013–2017 were investigated by first, mortality rates generated using Australian Bureau of Statistics death registrations where RHD was a coded COD, and second COD analyses of death records for a prevalent RHD cohort identified from RHD register and hospitalisations. All analyses were undertaken by Indigenous status and age group (0–24, 25–44, 45–64 years).ResultsAge-specific RHD mortality rates per 100 000 were 0.32, 2.63 and 7.41 among Indigenous 0–24, 25–44 and 45–64 year olds, respectively, and the age-standardised mortality ratio (Indigenous vs non-Indigenous 0–64 year olds) was 14.0. Within the prevalent cohort who died (n=726), RHD was the underlying COD in 15.0% of all deaths, increasing to 24.6% when RHD was included as associated COD. However, other cardiovascular and non-cardiovascular conditions were the underlying COD in 34% and 43% respectively.ConclusionPremature mortality in people with RHD aged <65 years has approximately halved in Australia since 1997–2005, most notably among younger Indigenous people. Mortality rates based solely on underlying COD potentially underestimates true RHD mortality burden. Further strategies are required to reduce the high Indigenous to non-Indigenous mortality rate disparity, in addition to optimising major comorbidities that contribute to non-RHD mortality.

Rheumatic heart disease (RHD) comprises heart-valve damage caused by acute rheumatic fever (ARF). The Australian Government Rheumatic Fever Strategy funds RHD Control Programs to support detection and management of ARF and RHD. We assessed epidemiological changes during the years of RHD Control Program operation.

To describe self-reported bowel cancer screening participation, beliefs and attitudes in a sample of New South Wales (NSW) adults, and to identify beliefs and demographic factors associated with self-reported bowel cancer screening participation. This study used data from the International Cancer Benchmarking Partnership Module 2, a representative populationbased telephone survey. Self-reported participation in and beliefs about bowel cancer screening were measured using the Awareness and Beliefs about Cancer survey of people aged 50 years and over living in NSW, Australia (n = 2001). Logistic regression modelling was used to identify explanatory variables associated with bowel cancer screening participation. Half of all women (54.1%, 95% CI: 50.8–57.4%) and two-thirds of men (65.7%, 95% CI: 61.5–69.9%) reported screening for bowel cancer within the previous 5 years. Believing that screening was only necessary when experiencing symptoms was more likely to be endorsed by people aged 65 years and over (25.5%, 95% CI: 22.2–28.7%) rather than younger (50–64 years; 16.7%, 95% CI: 13.8–19.7%), non-English-speaking migrants (35.4%, 95% CI: 26.7–44.1%) versus others (18.6%, 95% CI: 16.4–20.7%), and people in metropolitan (23.3%, 95% CI: 20.4–26.1%) versus non-metropolitan areas (16.4%, 95% CI: 12.8–20%). People who disagreed that screening was only necessary when experiencing symptoms were four times more likely to report screening participation (OR 3.96, 95% CI: 3.11–5.03). Community education about bowel cancer screening is needed to correct misperceptions regarding screening in the absence of symptoms. Tailored strategies for older, migrant and urban communities may be beneficial. Education strategies that promote the need for screening in the absence of symptoms and correct misconceptions about bowel cancer screening amongst subgroups of the NSW population may improve screening rates and decrease the burden of bowel cancer in NSW. Results from a population-based telephone survey of New South Wales adults were used to identify beliefs predicting participation in bowel cancer screening, as well as groups most likely to hold those beliefs. Education strategies promoting the need for screening in the absence of symptoms and correcting misconceptions about bowel cancer screening among subgroups of the New South Wales population may improve screening rates.