Diagnosing bowel cancer at an early stage significantly improves survival outcomes and is the primary objective of screening programs across the globe. The Australian National Bowel Cancer Screening Program (NBCSP) aims to detect early signs of the disease through immunochemical faecal occult blood tests (iFOBTs). General practitioners (GPs) are at the forefront of patient participation and progression along the screening pathway.
This project aimed to qualitatively investigate Western Australian GPs’ management of iFOBT positive NBCSP patients and explore ways to optimise program effectiveness from the GP perspective.
The project utilised an explanatory, sequential mixed method design via a modified Delphi technique. Results from the first Delphi round semi-structured interviews with 16 GPs guided the second Delphi round, which was an online questionnaire completed by 14 GPs. Metropolitan-based participants predominated, with diverse socioeconomic demographics.
NBCSP participation and progression were influenced by the efficiency of clinic processes, clinical system integration with the National Cancer Screening Register, and the strength of patient-doctor relationships. GPs employed various strategies to optimise program uptake and manage iFOBT positive NBCSP patients; however, these efforts were hindered by patient factors, including aversion to test type, inability to understand kit instructions, and underappreciation of screening importance.
Findings identify areas of improvement regarding the care and management of iFOBT positive NBCSP patients and inform on best practice to drive consistency and equity throughout Western Australia and similar settings.