GPs now able to bulk order bowel cancer screening kits

Morgan Liotta

2/05/2023 4:40:08 PM

The new alternative access model aims to reduce barriers by allowing GPs to hand kits directly to eligible patients during consultations.

Patient holding test kit with GP
Under the alternative access to kits model, GPs can give kits directly to eligible patients, explain why the test is important and demonstrate how to do it.

The National Bowel Cancer Screening Program (NBCSP) has developed a new alternative access to kits model in a bid to remove barriers and strengthen GPs’ role in the screening process.
Launched as part of a phased rollout that began late last year, the new initiative is seeking to encourage people who have never screened or are overdue for screening to participate in the program.
It means healthcare providers can now bulk order NBCSP kits and issue them directly to eligible patients during an appointment, explain why the test is important and demonstrate how to do it.
Professor of Primary Care Cancer Research, Jon Emery, who sits on the NBCSP Clinical Advisory Committee, told newsGP the updated model is an important initiative which will hopefully lead to GPs being more engaged in promoting and delivering the screening program.
‘The alternative access model is an important development in the NBCSP,’ he said.
‘GPs can identify under-screened patients and provide them with the kit directly. If we can reach 60% participation in the NBCSP, we could save an additional 84,000 lives by 2040.’
Preliminary Australian Institute of Health and Welfare data for 2020–21 shows that less than half (40.9%) of people aged 50–74 who were invited to screen in the NBCSP participated, with participation slightly higher among women (42.8%) than men (38.9%).
Given access to bowel cancer screening kits via GPs is a move the RACGP has long been calling for, Professor Emery sees the alternative access model as ‘definitely a good outcome’ for the college.
‘The RACGP has been making a strong case for greater involvement of general practice in the implementation of the NBCSP as a key strategy to increase bowel cancer screening in Australia,’ he said.
According to the NBCSP, patients are more likely to complete the test after discussing the process with a trusted healthcare provider, who play an important role in helping make informed decisions about bowel cancer screening.
Additionally, following first-time screening, people are more likely to continue routine screening, with the program’s data showing that while only 32% of people complete their first test, after screening for the first time 82% do it again.
‘There is good evidence that a brief discussion by a GP or practice nurse about bowel cancer screening makes it more likely that a patient will complete the NBCSP kit,’ Professor Emery said.
‘[And] once someone has completed a NBCSP kit, they are far more likely to continue screening.’
If detected early, more than 90% of bowel cancers can be successfully treated, with screen-detected bowel cancers less likely to cause death than bowel cancers diagnosed in people never invited to screen in the NBCSP.
The alternative access model also provides an opportunity to engage with known under-screened cohorts, including Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse populations, rural and remote communities, and men aged 50–55.
The new model builds on the National Indigenous Bowel Screening Pilot, which saw Aboriginal and Torres Strait Islander participation in bowel screening increase from 27% to almost 40% among the pilot participants.
‘Through the pilot, direct healthcare provider engagement has already been shown to increase bowel cancer screening in Aboriginal and Torres Strait Islander people,’ Professor Emery said.
‘Extending the alternative access model means that general practice can become more directly involved in the delivery of the NBCSP and increase participation, especially in populations who are less likely to screen.’
For culturally appropriate training, the NBCSP recommends that Aboriginal Community Controlled Health Organisations contact the National Aboriginal Community Controlled Health Organisation (NACCHO).
All kits handed to patients must be recorded by the GP or other healthcare provider in the National Cancer Screening Register (NCSR) to ensure the samples can be tested and the results sent to the correct address.
Professor Emery also offered some practical advice for GPs wanting to become more engaged in promoting and delivering the screening program.
‘An important first step in using the alternative access model is ensuring your practice software is integrated with the NCSR,’ he said.
‘GPs and practice nurses need to become familiar with using the Healthcare Provider Portal of the NCSR as the way of bulk ordering NBCSP kits.
‘When providing a NBCSP kit to your patient, you need to provide them with the participant details form, the equivalent of a test request, which can be accessed via the NCSR hub from within your clinical software.’
To order the screening kits, practices can:

Bowel screening kits cannot be ordered in bulk via clinical software.
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