The role of health professionals in the National Bowel Cancer Screening Program

Manage participants via the National Cancer Screening Register

The program is supported by the National Cancer Screening Register (NCSR), which invites, reminds and follows up participants to screen. It also generates comprehensive data to inform public health policy and improve program quality and service delivery.

The NCSR Healthcare Provider Portal is a secure environment to access and submit screening data – as well as bulk order bowel screening kits and register kits issued to patients as part of the alternative access to kits model.

Use the portal to:

• bulk order bowel screening kits for your practice and register a kit issue to a patient
• access your patient’s bowel and cervical screening results and histories online
• prepare for patient appointments by checking if they are due for screening or follow up
• submit forms and reports electronically
• update your patient’s information
• order a bowel screening kit to be sent to a patient’s home address.

Role of general practitioners and practice nurses

You play an important role in supporting eligible patients to participate in bowel cancer screening.

To support your patients to screen for bowel cancer you can:

• promote the program in your practice with free brochures and posters
• talk to your patients aged 49 to 74 about screening
• show patients how to use a bowel screening test kit
• help patients complete the participant forms
• do a screening audit of practice records and send a letter to 49-year-old patients to encourage participation in the program
• refer patients (of any age) with symptoms, bowel disease or family history of bowel disease to a doctor.
• read Promoting bowel screening in general practice
• manage patients according to the evidence-based Clinical practice guidelines for the prevention, early detection and management of colorectal cancer (Clinical practice guidelines) 

The Clinical practice guidelines also provide guidance for managing patients:

• identified as being at increased risk of bowel cancer
• of any age, presenting with signs or symptoms of bowel cancer.

Encouraging patients to screen for bowel cancer

Many patients are more likely to complete the test after discussing the process with a trusted healthcare provider. You play an important role in helping your patients make informed decisions about bowel cancer screening.

Get conversation starters and learn more about encouraging patients to screen.

Ask your patient if they have any concerns about doing the test at home? 

Show them an open test kit and explain how to use it, and show them the walk-through video.

We have translated the test kit instructions into 22 languages.

You can order demonstration kits from us.

Send a letter or text message to your patients

Research shows that endorsement by the patient’s doctor is an effective way to increase participation in bowel cancer screening.

Currently, 50-year-olds have the lowest participation rate in the program. Consider sending a letter to 49-year-old patients encouraging them to do the test when they receive it in the mail after they turn 50.

Use this letter template to recommend screening to patients.

Alternatively, you may wish to send the following SMS to your 49-year-old patients:

You could also encourage your 50 to 74-year-old patients to participate by sending the following text:

Health service providers have obligations under the Privacy Act 1988 and relevant state and territory privacy laws when handling personal information. The template letter has been drafted to comply with relevant privacy obligations. If you alter the letter before you send it to your patients, you should consider whether it still meets the privacy obligations.

If you have any queries about your privacy obligations, please email or call the Office of the Australian Information Commissioner.

Patient test results

The patient and their nominated healthcare provider will be mailed a copy of the results.

A positive result means blood has been detected in one or both samples. This does not mean the patient has bowel cancer, but further investigation is needed to find out why the blood is there.

If your patient receives a positive result:

• Contact the patient to arrange a follow up appointment.
• If referring for colonoscopy, complete a referral and state the patient has a positive iFOBT as a NBCSP participant (this ensures they are waitlisted as category 1).
• Offer your patient a colonoscopy information brochure or direct them to colonoscopy: what you need to know.
• Notify the National cancer Screening Register about the referral (or non-referral) for colonoscopy via:
  • electronic form in the HCP Portal
  • the NCSR Hub in your clinical software (if integrated with the register) or
  • fax or post using the GP Assessment form.

Learn more about bowel screening test results.

Role of colonoscopists and pathologists

Gastroenterologists, colonoscopists, surgeons and pathologists play a key role in ensuring patients progress through the screening pathway.

For your patients, you can:

• manage patients according to the evidence-based Clinical practice guidelines for the prevention, early detection and management of colorectal cancer 
• identify program participants when assessing them during a colonoscopy referral to help with reporting to the register
• report to the register’s Healthcare Provider Portal or via the relevant program form:
  • colonoscopy outcomes and any follow-up testing or treatment for a patient with a positive test result
  • results of a colonoscopy or surgical resection and histopathology results
  • adverse events that may have occurred during the course of treatment.

Clinical guidelines and resources

Clinical guidelines

• Clinical practice guidelines for prevention, early detection and management of colorectal cancer – these NHMRC approved guidelines cover all aspects of bowel cancer care
• Colonoscopy Clinical Care Standard – provides guidance on colonoscopy
• Clinical practice guidelines for surveillance colonoscopy – these guidelines cover the appropriate use of colonoscopy in preventing bowel cancer
• RACGP Guidelines for preventive activities in general practice – Red Book: Section 9.2: Colorectal cancer – provides guidance on bowel cancer screening.

Clinical resources

See our collection of resources for health professionals.

Additional resources:

• Cancer Screening Education for General Practitioners is a free online course covering all three national cancer screening programs. Developed by True Relationships & Reproductive Health and the Queensland Cancer Screening Unit.
• Guide for nurses working in general practice contains bowel cancer screening resources and training, developed by the Australian Primary Healthcare Nurses Association in partnership with Cancer Council WA helped and funded by the Department of Health and Aged Care.
• Bowel screening flipchart and facilitator manual – developed by the Cancer Institute NSW to help you provide education on bowel cancer and bowel cancer screening to people from different cultural backgrounds. Available in English, it’s also translated into 11 different languages.
• QLD Health – bowel screening information video – this 3-minute video provides an overview of the program, the effectiveness of the screening test over colonoscopy for screening people with an average risk of bowel cancer, and the role of doctors in bowel cancer screening.

Impact of COVID-19 on bowel cancer screening

With the impact of the COVID-19 pandemic straining the health system, there might still be delays for follow-up medical appointments, tests or procedures.

Continue to refer your patients to colonoscopy services for further investigation, where appropriate. Patients without symptoms might have to go on a waiting list. A small delay is likely to be very low risk, as most bowel cancers are slow growing. Patients with any concerns should talk to their doctor.

We asked Cancer Council NSW to model the possible impact of COVID-19 on our 3 national cancer screening programs. They examined a variety of scenarios and analysed the potential impact. Read their reports.