Background and Context:
The National Bowel Cancer Screening Program (NBCSP) commenced in Western Australia (WA) in January 2007. Histopathology outcome reporting was poor (<10%) and has limited program assessment1. WA Health instigated an innovative data retrieval approach to trace histopathology outcomes on participants in 2009. Our project, an Australian first, involves cross referencing NBCSP participants with pathology laboratories to track histopathology data.
Aim:
To collect histopathology data for NBCSP participants in WA and facilitate program monitoring and evaluation.
Strategy/Tactics:
Participants with positive FOBT results (n=8,716; January 2007 to June 2012) were identified by the NBCSP Register and cross-matched to four laboratory databases (representing 91% of colorectal pathology reporting in WA) to ascertain histology findings. Reports were provided to the national NBCSP Register for inclusion in the national dataset.
Programme/Policy Process:
The project was instigated by WA Health, with extensive collaboration from four WA pathology laboratories, the Commonwealth Department of Health and Medicare Australia.
Outcomes/What was learned:
The project has identified 5,020 histopathology reports (4,762 colonoscopic biopsies and 258 resections). In total, 269 NBCSP participants had a cancer identified (5.4%; M=64%; F=36%; p=<0.001); prior to project commencement, only nine cancers in WA had been recorded on the NBCSP Register after two years of the program. Of cancers with staging information, 36.8% (57/155) were stage I disease, suggesting a staging shift to earlier diagnosis among NBCSP participants.
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, administrative redesign and the prioritisation of a national automated data transfer trial between the NBCSP Register and pathology laboratories. Our project continues; all partners are committed until automated data transfer is implemented. This innovative approach has since been adopted by several other jurisdictions nationally.