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Enhancing Bowel Screening Rates in General Practice

Bowel cancer is one of the most common cancers in Australia, and we have one of the highest rates globally. When found early, more than 90% of cases can be successfully treated.1

The National Bowel Cancer Screening Program (NBCSP) recommends completing the free iFOBT test every two years, sent to eligible people aged 50–74. As of 2024, the eligibility age has been lowered to 45 — people aged 45–49 can now request their first kit through a simple online order form.

Private kits are not recommended for routine screening, as they are not tracked by the national program.

Participation in bowel screening is declining nationally — from 43.8% (2019–20) to 40.9% (2020–21).2

In the CCQ region, rates sit just below at 40.8%, with Central Queensland at 34.5%.2

Screening rates are lowest among:3

  • People aged 45–55 (especially men)
  • Aboriginal and Torres Strait Islander peoples
  • Culturally and linguistically diverse communities
  • People with disabilities
  • Those experiencing social disadvantage

Primary care providers play a critical role in improving screening rates through the National Bowel Cancer Screening Program through:  

  • Trusted patient relationships
  • Accessibility and preventative care delivery
  • Opportunistic screening during routine appointments

Research shows that strong primary care involvement is directly linked to increased cancer screening participation. 

Healthcare providers can now bulk order and issue bowel screening kits directly to their eligible patients through the alternative access to kits model. This is in addition to the existing mail out model. See below resources for more information.

This QI Toolkit helps your practice:

  • Identify eligible patients
  • Set achievable goals and track your progress
  • Access tailored tools, data reports, and support
  • Engage your team and embed improvements into everyday care

CCQ has developed a bold consumer-facing bowel screening campaign targeting 45–49 year old men; a group with particularly low participation rates.

The Post Your Poo campaign will launch in late May and run throughout June, using humour, cut-through and community engagement to shift perceptions and drive screening uptake.

We encourage practices to align their efforts with this public campaign to help reinforce key messages and encourage follow-through from patients.

Together, we can create a consistent, memorable message and lift bowel screening rates where they matter most.

Locally-developed consumer campaign

Digital Campaign Resource Kit for general practice coming soon!

Bowel cancer is one of the most common cancers in Australia, with Australia having one of the highest rates of bowel cancer in the world.1 When found early, more than 90% of cases can be successfully treated.2

Watch this short video to hear from Dr Peter Dobson, local GP and CCQ Board Director.

The National Bowel Cancer Screening Program (NBCSP) plays a critical role in reducing mortality by supporting early detection through the free immunochemical faecal occult blood test (iFOBT). With recent updates lowering the eligibility from 50 to 45, the program now enables earlier engagement in screening.

The participation rate in bowel cancer screening has dropped from 43.8% in 2019–2020 to 40.9% in 2020–2021.2 The CCQ region sits just below at 40.8% participation, however, noting the lowest participation rates occurring in Central Queensland at 34.5% on average.1 Screening rates are lowest amongst the following population groups: those aged 45-55, particularly men, Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse communities, people with disabilities and those experiencing social disadvantage.3

Primary care providers play a critical role in driving bowel screening participation through their trusted relationships, clinical expertise and accessibility to engage patients in preventative care. Research suggests that strong primary health care involvement is associated with greater cancer screening participation rates.3

This QI Toolkit focuses on how to identify and engage eligible patients in bowel cancer screening and increase participation rates in your practice.

📢 New local consumer campaign (May/June)

CCQ has developed a bold consumer-facing bowel screening campaign targeting 45–49 year old men; a group with particularly low participation rates.

The Post Your Poo campaign uses humour, cut-through messaging and community engagement to shift perceptions and drive screening uptake.

We encourage practices to align their efforts with this public campaign to help reinforce key messages and encourage follow-through from patients. 

Download the Campaign's Digital Resources Kit

Getting started

Increase bowel screening participation in eligible practice population.

Tip: Find your baseline measure and set a target measure to be achieved in a certain timeframe to ensure your goal is achievable.

To achieve this goal, you can access a range of resources:

  1. Use HealthPathways to explore locally tailored approaches for bowel cancer screening and management. Simply enter “Bowel Cancer Screening” in the search bar to get started.
  2. Review current best practice clinical guidelines:

Kickstart your quality improvement activity by bringing together a quality improvement team. Together, you’ll identify the key challenges and come up with innovative solutions, ensuring you all share a clear understanding of the improvement objectives and strategies.

  1. Engage with your Primary Health Coordinator from CCQ; they can offer tailored support, resources and guidance to enhance your QI efforts wherever you are in your QI journey. Your Primary Health Coordinator can support your practice to:
    • Bring a QI team together to decide on an improvement idea
    • Plan, start and finish a QI activity
    • Facilitate QI meetings
    • Create practice-wide systems improvement
  1. Gather data and information. Review current practice data and processes for bowel cancer screening.
  2. Identify and discuss any common barriers to engagement in bowel cancer screening. Consider using process maps, flow charts or driver diagrams to generate change ideas and improve processes.

What data might you need? You’ll need data to understand the problem and measure your outcomes. We suggest you start with:

  1. Primary Sense can provide insight, detailed reports, and targeted guidance on improving data quality, specifically in relation to bowel cancer screening. The following report is available within Primary Sense:
    • Bowel and Breast Cancer Screening: Identifies patients who may be eligible for bowel cancer screening.
  1. The National Cancer Screening Register (NCSR) allows you to access and report patient clinical information for bowel cancer screening programs directly from your clinical software or via the Healthcare Provider Portal. Before starting your QI, ensure the NCSR is integrated with your practice software (Primary Care Onboarding Kit) and, if necessary, individual patient results from the NCSR are updated in your practice software. NBCSP kits can be ordered on behalf of the patient with their consent through the NCSR platform.   

To achieve your goal, you can consider several improvement ideas, such as:

  1. Utilise the Primary Sense report Bowel and Breast Cancer Screening to identify patients booked with missing bowel cancer screening and add a reminder into the practice software to prompt for opportunistic screening.
  2. Audit the practice bowel screening recall and reminder system by ensuring screening results are recorded correctly, inactive patients are deleted, and incorrect recalls and reminders are removed.
  3. Using the Primary Sense report Health Assessments, filter for eligible patients booked within the next two weeks and add a reminder to discuss bowel cancer screening during their appointment.
  4. Run a patient education campaign to inform patients about bowel cancer screening using the CCQ bowel cancer screening campaign resources (coming soon!). This could also include participating in community events. If the practice is in a ‘hot zone’1 for bowel screening, align your patient education campaign to the cooler months to ensure the most timely access.
  5. Ensure culturally appropriate resources are available for Aboriginal and Torres Strait Islander patients. For eligible patients, establish a standard that bowel screening conversations are part of the 715-health check. Consider partnering with your local AMS to support events for the community focusing on cancer screening.

Remember to self-report your QI project as a CPD activity. QI is a great tool for measuring tangible outcomes and demonstrating improvement in patient care!

Share your results with your CCQ practice support team and with your patients. Ensure you document your quality improvement activity to meet PIP QI guidelines and for CPD purposes.

References

    1. Cancer screening programs: quarterly data. National Bowel Cancer Screening Program – Bowel cancer screening participation: AIHW, Jul 2023, accessed 9 December 2024.
    2. National Bowel Cancer Screening Program | Australian Government Department of Health and Aged Care, accessed 9 December 2024.
    3. Lotfi-Jam KL, O’Reilly CL, Feng CS, Wakefield MA, Durkin S, Broun KH. Increasing bowel cancer screening participation: integrating population-wide, primary care and more targeted approaches. Public Health Res Pract. 2019;29(2):2921916.
Download PDSA Template

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Aboriginal and Torres Strait IslandersCCQ acknowledges the Traditional Custodians of the land on which we work and live, and recognises their continuing connection to land, waters and community. We pay our respect to them and their cultures; and to Elders past, present and emerging.

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