Abstract: Bowel cancer is the third most common cancer for Indigenous Australians, after lung and breast cancer in women, and lung and prostate cancer in men. It accounts for around 10% of all cancers. It is rarely noted as a significant health issue for Indigenous people with incidence and deaths from bowel cancer much lower than in the non-Indigenous population. However, under-ascertainment of Indigenous status in cancer registries and other factors may mean Indigenous cancers are significantly underestimated. In 2002 a pilot program for bowel cancer screening commenced in Australia in Melbourne, Adelaide and Mackay. The Final Evaluation Report of the Bowel Cancer Screening Pilot Program showed that a national bowel cancer screening program would be feasible, acceptable and cost effective in Australia. After the pilot program completed in 2004, screening was extended to all people who were turning 50, 55 or 65 years. In 2008 the program was suspended due to a problem with the sampling kits giving false negative results when exposed to too much heat. A new kit was developed and the program restarted in 2009. Milingimbi is an Aboriginal community on an island in the Arafura Sea, 400km east of Darwin and approx 200km west of Nhulunbuy. It is only ½ km off the mainland and part of the Crocodile Island Group in the northeast Arnhem region of the Northern Territory. It has a tropical climate. There are approximately 1500 Yolngu people resident on Milingimbi. Prior to moving to the NT, I worked for 5 years in the prevention area of the NSW Cancer Council. I have since been working in a regional public health role and live in Milingimbi. I work alongside the Aboriginal Community Workers and together we form the public health and community team. The Community Worker role is relatively new in the NT and focuses on community liaison, cultural brokering and health promotion. The Community Workers enrich the relevance and contribute to the effectiveness of the health service. Chronic conditions such as diabetes, renal disease, rheumatic heart disease, pulmonary disease and heart disease pose the biggest threat to the health and wellbeing of Milingimbi residents. Many children have skin infections and growth faltering. Significant issues that continue to contribute to ill health are smoking, poor housing and overcrowding. In East Arnhem the adult smoking prevalence is 76%.