The National Bowel Cancer Screening Program (NBCSP) commenced in Western Australia (WA) in January 2007. Historically, histopathology reporting was poor (<10%) and limited program monitoring and evaluation. Since 2009, WA Health has conducted a data retrieval project tracing histopathology outcomes on participants.
To collect histopathology outcomes on WA NBCSP participants and support program monitoring and evaluation.
NBCSP participants with positive immunochemical faecal occult blood test results (n=10,817) were identified by the NBCSP Register over six rounds covering the period January 2007 to June 2013. Participants were cross-matched to four laboratory databases (representing 91% of colorectal pathology reporting in WA) by NBCSP-specific project officers to identify histology findings. Transcribed reports were submitted to the national NBCSP Register for processing.
Records of 10,817 NBCSP participants reviewed in the first six rounds of the Histology Data Collection Project (HDCP) have identified 6,114 histopathology reports reflecting a 57% hit-rate (colonoscopic biopsies=5,817; 95% and resections=297; 5%). Pathology findings were significantly more prevalent among males (60%; n=3,266; x2= 71.6; p=<0.001) than females (40%; n=2,198).
In total, 3,563 NBCSP participants had adenomas identified (65%; M=65%, F=35%; p=<0.001) and 317 with cancer (6%; M=62%, F=38%; p=<0.001). When our project commenced in 2009, the NBCSP Register had only two cancers recorded for WA. Of cancers identified with pathological staging information, 35% (63/178) of cancers detected at resection were Stage I disease, suggesting a shift to earlier stage of diagnosis among NBCSP participants in WA corresponding to national literature.
Our project has enhanced the completeness of histopathological data for NBCSP participants and has significantly contributed to the national dataset. Outcomes have driven program change in data collection and administrative redesign. Our project continues; all partners are committed until automated data transfer is in place. Several other jurisdictions have adopted this innovative approach.