Background: In Australia, a large proportion of people are unnecessarily screened for colorectal cancer (CRC) with colonoscopies and many at higher risk of CRC are not being screened with colonoscopies. Providing general practitioners (GPs) with a tool to determine their patient’s individual risk of CRC will assist in providing accurate screening advice, making colonoscopic screening more efficient and effective.
Aim: Our vision is to implement a personalised approach to screening to reduce CRC by optimising evidence-based screening. The CRE team aim: (a) to develop the first personalised CRC risk tool that incorporates genetic, pathology, family history, lifestyle factors and personal characteristics, and (b) to develop proven methods for implementing these tools in general practice.
Methods: Beginning with a prediction tool prototype (while the statistical development of the prediction tool is underway using the data from the Colon Cancer Family Registry), we will ‘unpack’ the many components involved in implementing an intervention in primary care, following a step-wise approach based on the Medical Research Council framework for the development and evaluation of complex interventions (UK). The initial phase of the study has begun with an analysis of the theoretical underpinning of the intervention with a systematic review (phase 0) and a pilot of the tool (phase 1). The pilot involved testing the tool with GPs in a simulated consultation in their own clinic with an actor playing the role of patient. This method aims to capture data that represents the ‘real’ clinical use of the tool.
Results: Phase 0 and Phase 1 are anticipated to be completed in May 2014.Using the tool in situ with GPs is providing rich qualitative data which will inform the next phases of the study.
Conclusions: The results are essential for the design of a randomised controlled trial to test the prediction tool and implementation methods in GPs.