Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Implementation of colorectal cancer risk prediction in primary care. (#37)

Jon Emery 1
  1. Department of General Practice and Centre for Cancer Research, University of Melbourne, Carlton, VIC, Australia


Population bowel cancer screening in Australia involves direct-to-consumer invitations to participate, with limited involvement of primary care until someone has a positive faecal occult blood test. This model assumes a one-size fits all approach and fails to account for variations in colorectal cancer risk. Current participation in the National Bowel Cancer Screening Program is poor with only 41% of people returning the faecal occult blood test kit. Importantly, over one million Australians at average risk of bowel cancer are having unnecessary and potentially harmful colonoscopy screening rather than doing the faecal occult blood test.  Greater involvement of primary care in cancer screening programs is associated with higher participation rates.

If we are to implement precision screening for colorectal cancer, this will require involvement of  primary care to determine a patient’s risk and promote risk-appropriate screening, including at what age to start and with which screening test. In this presentation I will discuss our research on approaches to implement colorectal cancer risk assessment and tailored screening in primary care, including electronic risk assessment tools (e.g. the CRISP Trial) and genomic testing using a SNP panel.  I will discuss the implementation challenges of these different approaches and consider how we might eventually incorporate new models to provide tailored bowel cancer screening in Australia.

  1. The use of a risk assessment and decision support tool (CRISP) compared with usual care in general practice to increase risk-stratified colorectal cancer screening: study protocol for a randomised controlled trial Jennifer G. Walker, Finlay Macrae, Ingrid Winship, Jasmeen Oberoi, Sibel Saya, Shakira Milton, Adrian Bickerstaffe, James G. Dowty, Richard De Abreu Lourenço, Malcolm Clark, Louise Galloway, George Fishman, Fiona M. Walter, Louisa Flander, Patty Chondros, Driss Ait Ouakrim, Marie Pirotta, Lyndal Trevena, Mark A. Jenkins and Jon D. Emery Trials 2018 19:397 https://doi.org/10.1186/s13063-018-2764-7