Improving Australian National Bowel Cancer Screening Program outcomes through increased participation and cost-effective investment

Worthington, Joachim; Lew, Jie-Bin; Feletto, Eleonora; Holden, Carol A; Worthley, Daniel L.; Miller, Caroline; Canfell, Karen

doi:10.1371/journal.pone.0227899

Cited by 21 publications

(18 citation statements)

References 29 publications

(41 reference statements)

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“…Despite the recognized benefits that screening offers, CRC screening uptake around the world is still suboptimal, with the rates below 50% in many countries and regions [11][12][13][14]. Considerable efforts have been made to increase CRC screening uptake.…”

Section: Introductionmentioning

confidence: 99%

Colorectal Cancer Screening: Have We Addressed Concerns and Needs of the Target Population?

Tran

Ferrari

Hoeck

et al. 2021

Gastrointestinal Disorders

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Despite the recognized benefits of colorectal cancer (CRC) screening, uptake is still suboptimal in many countries. In addressing this issue, one important element that has not received sufficient attention is population preference. Our review provides a comprehensive summary of the up-to-date evidence relative to this topic. Four OVID databases were searched: Ovid MEDLINE® ALL, Biological Abstracts, CAB Abstracts, and Global Health. Among the 742 articles generated, 154 full texts were selected for a more thorough evaluation based on predefined inclusion criteria. Finally, 83 studies were included in our review. The general population preferred either colonoscopy as the most accurate test, or fecal occult blood test (FOBT) as the least invasive for CRC screening. The emerging blood test (SEPT9) and capsule colonoscopy (nanopill), with the potential to overcome the pitfalls of the available techniques, were also favored. Gender, age, race, screening experience, education and beliefs, the perceived risk of CRC, insurance, and health status influence one’s test preference. To improve uptake, CRC screening programs should consider offering test alternatives and tailoring the content and delivery of screening information to the public’s preferences. Other logistical measures in terms of the types of bowel preparation, gender of endoscopist, stool collection device, and reward for participants can also be useful.

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Section: Introductionmentioning

confidence: 99%

Colorectal Cancer Screening: Have We Addressed Concerns and Needs of the Target Population?

Tran

Ferrari

Hoeck

et al. 2021

Gastrointestinal Disorders

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“…7 Increasing the screening participation rate to at least 60% (and the rate of diagnostic assessment follow-up to 90%) will maximise the mortality benefit from the NBCSP. 8 Communitytargeted initiatives (such as mass media campaigns 9 ) have shown some success in increasing screening participation, and primary care is also well placed to reach non-adherent patients for both screening and follow-up.…”

mentioning

confidence: 99%

General practice perspectives on a bowel cancer screening quality improvement intervention using the Consolidated Framework for Implementation Research

Holden¹,

Turnbull²,

Frank³

et al. 2021

Public Health Res Pract.

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“…15 We also explored the impact of optimistic NBCSP adherence rates, possibly beyond those achievable in practice, to determine whether the impact of such an intervention is substantial and worth pursuing further. 55 Alternative screening methods using different NBCSP screening modalities or different screening age groups have also been evaluated. 20 21 The alternative technologies evaluated were plasma DNA testing, faecal DNA testing, CT colonography, flexible sigmoidoscopy and colonoscopy.…”

Section: Preliminary Resultsmentioning

confidence: 99%

Pathways to a cancer-free future: a protocol for modelled evaluations to minimise the future burden of colorectal cancer in Australia

et al. 2020

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IntroductionWith almost 50% of cases preventable and the Australian National Bowel Cancer Screening Program in place, colorectal cancer (CRC) is a prime candidate for investment to reduce the cancer burden. The challenge is determining effective ways to reduce morbidity and mortality and their implementation through policy and practice. Pathways-Bowel is a multistage programme that aims to identify best-value investment in CRC control by integrating expert and end-user engagement; relevant evidence; modelled interventions to guide future investment; and policy-driven implementation of interventions using evidence-based methods.Methods and analysisPathways-Bowel is an iterative work programme incorporating a calibrated and validated CRC natural history model for Australia (Policy1-Bowel) and assessing the health and cost outcomes and resource use of targeted interventions. Experts help identify and prioritise modelled evaluations of changing trends and interventions and critically assess results to advise on their real-world applicability. Where appropriate the results are used to support public policy change and make the case for optimal investment in specific CRC control interventions. Fourteen high-priority evaluations have been modelled or planned, including evaluations of CRC outcomes from the changing prevalence of modifiable exposures, including smoking and body fatness; potential benefits of daily aspirin intake as chemoprevention; increasing CRC incidence in people aged <50 years; increasing screening participation in the general and Aboriginal and Torres Strait Islander populations; alternative screening technologies and modalities; and changes to follow-up surveillance protocols. Pathways-Bowel is a unique, comprehensive approach to evaluating CRC control; no prior body of work has assessed the relative benefits of a variety of interventions across CRC development and progression to produce a list of best-value investments.Ethics and disseminationEthics approval was not required as human participants were not involved. Findings are reported in a series of papers in peer-reviewed journals and presented at fora to engage the community and policymakers.

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Improving Australian National Bowel Cancer Screening Program outcomes through increased participation and cost-effective investment

Cited by 21 publications

References 29 publications

Colorectal Cancer Screening: Have We Addressed Concerns and Needs of the Target Population?

Colorectal Cancer Screening: Have We Addressed Concerns and Needs of the Target Population?

General practice perspectives on a bowel cancer screening quality improvement intervention using the Consolidated Framework for Implementation Research

Pathways to a cancer-free future: a protocol for modelled evaluations to minimise the future burden of colorectal cancer in Australia

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