Bowel cancers are the fifth-most common form of cancer in Australia and are responsible for 10 percent of all deaths for cancer. But among Australians living with an intellectual disability, that mortality rate is more than twice as high. Researchers from the University of Sydney and the University of Glasgow are determined to fix that gap with the help of voice-powered AI assistants.

“We know that bowel cancer screening saves lives,” said Dr Julie Ayre, Senior Research Fellow in the Sydney Health Literacy Lab in the Faculty of Medicine and Health’s School of Public Health. “If found early, more than 90 percent of bowel cancer cases can be treated effectively.”

The Australian National Bowel Cancer Screening Program provides free, at-home testing kits to Australians between the ages of 45 and 74. However, Dr Ayre said that only 42 percent of people who are invited to take part in the program actually follow through.

“This number is even lower for people with intellectual disabilities, which contributes to a mortality rate nearly 2.5 times higher than in the rest of the population. Our research program looked at why people with intellectual disabilities are less likely to take part in screening programs and how we can work with them to increase uptake of these potentially life-saving tests.”

Working with Professor Katie Robb and her colleagues in Glasgow, where Scotland faces a similar problem with its own bowel cancer screening program, the researchers found that the existing public health campaigns and information materials about bowel cancer screening aren’t meeting this community’s needs.

“So we’re partnering with the community to co-design a new, AI-powered solution that can make it easier to understand the screening process and why it matters, in a more comfortable setting,” said Dr Ayre.

Professor Robb added: “Ultimately we hope this tool can increase participation in screening for people who want to take part so that we are more likely to catch any cancers in the early stages when treatment is most effective.”

The researchers developed the ‘Voice AI’ tool to connect users to existing resources, such as the Easy Read bowel cancer screening information, and turn the evidence-based guidance into personalised advice tailored to each user’s needs.

“It really complements current education and consent processes, rather than replacing them,” said Dr Ayre.

“Notably, since the project began, AI technology has progressed and we have been able to capitalise on these improvements by incorporating a large language model with Retrieval Augmented Generation (RAG) into the tool.”

As a result, the tool no longer relies on structured ‘scripts’ and can instead more flexibly answer any relevant question that the user asks, whilst drawing from a curated library of trusted resources.

The project is part of a larger investigation by the Sydney Health Literacy Lab into how assistive technologies like AI agents can be used responsibly to make healthcare more accessible and equitable for people with disabilities.

“People generally find generative AI tools quite easy to use and they give people information in a format that often meets their needs more appropriately than official information sources,” Dr Ayre said. “Bowel cancer screening is a good place to start because people often have questions about how to do bowel cancer screening but can feel self-conscious about talking about this topic with a real person.”

The research team also worked to address accessibility and privacy concerns during this proof-of-concept trial.

Participants accessed Voice AI by telephone call – a simpler solution than downloading an app to a smartphone. This limits the amount of personal data that could be obtained, and means there’s no need to bring a device with a camera into the bathroom.

“As a proof-of-concept, this study is also providing valuable insights about how people with intellectual disabilities feel about AI health tools, including what needs to be in place so that they feel safe using them,” Dr Ayre added.