Volume 202 - Issue 4
A bowel cancer screening plan at last
Authors: Oliver R Frank and Nigel P Stocks
Med J Aust 2015; 202 (4): 180. || doi: 10.5694/mja14.01547
Published online: 2 March 2015
Published online: 2 March 2015
General practice needs to be the pivot in the national screening program
To the Editor: The National Bowel Cancer Screening Program (NBCSP) sees general practitioners as “critical partners”,1 but has not really involved or supported GPs, who have personal frequent contact with a large proportion of the NBCSP's target population. GP endorsement increases uptake,2,3 but the NBCSP does not fund GPs to send reminder letters to their patients.
The NBCSP informs GPs about who has used a faecal occult blood test (FOBT) kit and returned samples, but it sends these reports on paper, which creates extra work of scanning results into patients' electronic clinical records and, more importantly, prevents GPs' clinical software from automatically generating appropriate reminders. Automated reminders can be displayed onscreen to GPs during consultations, and now can also be given to patients when they arrive for consultations, as printed prevention summaries based on current data in the patient's electronic clinical record.4,5
Uptake of bowel cancer screening is likely to be greater if general practice is a true partner in the process, as occurs in the cervical screening program. Following this model, the NBCSP would perform a back-up function to notify the person's usual GP or usual general practice if an FOBT result has not been received within 3 to 6 months of it becoming due. We concur with the statement: “it will become increasingly important to consult closely with the primary care sector and provide support to GPs to facilitate their role in the expanded NBCSP”. General practice must be made more central in the NBCSP for it to succeed.
Competing interests
Oliver Frank is the GP representative on the South Australian State Reference Group of the National Bowel Cancer Screening Program and receives remuneration from SA Health for attending meetings of this group.
References
- Grogan PB, Olver IN. A bowel cancer screening plan at last [editorial]. Med J Aust 2014; 201: 435-436. 1
- Hewitson P, Ward AM, Heneghan C, et al. Primary care endorsement letter and a patient leaflet to improve participation in colorectal cancer screening: results of a factorial randomised trial. Br J Cancer 2011; 105: 475-480. doi: 10.1038/bjc.2011.255. 2
- Zajac IT, Whibley AH, Cole SR, et al. Endorsement by the primary care practitioner consistently improves participation in screening for colorectal cancer: a longitudinal analysis. J Med Screen 2010; 17: 19-24. 3
- Frank OR, Stocks NP, Aylward P. Patient acceptance and perceived utility of pre-consultation prevention summaries and reminders in general practice: pilot study. BMC Fam Pract 2011; 12: 40. doi: 10.1186/1471-2296-12-40. 4
- Frank O, Aylward P, Stocks N. Development of pre-consultation prevention summary and reminder sheets for patients: preliminary study of acceptability and sustainability. Aust Fam Physician 2014; 43: 310-314. lefthere