Background
Early-onset colorectal cancer (EOCRC) is increasing in incidence in Australia and is frequently diagnosed at an advanced stage. Patients living in rural and remote regions face additional barriers to accessing multidisciplinary expertise, particularly for complex metastatic disease where repeated reassessment may create opportunities for potentially curative treatment. We developed a national virtual multidisciplinary team (MDT) model through Bowel Cancer Australia to improve equitable access to expert multidisciplinary decision-making for people with EOCRC, irrespective of geographical location.
Methods
The Bowel Cancer Australia EOCRC MDT is a nationally coordinated, virtual advisory MDT accepting referrals from treating clinicians, with patient self-referral also supported. The model prioritises patients with metastatic EOCRC, particularly those from regional and rural Australia. Recommendations are developed by a multidisciplinary panel including medical oncology, colorectal surgery, hepatobiliary surgery, radiation oncology, radiology and other disciplines as required. The model emphasises longitudinal reassessment, preservation of radical-intent treatment where appropriate, and integration with local treating teams. Prospective collection of implementation and outcome data is undertaken through the RIIO (Radical Intent Intervention Outcomes) Registry.
Results
The program has established a national referral pathway providing timely access to specialist EOCRC multidisciplinary expertise across state boundaries. Early implementation has demonstrated the feasibility of a consumer-supported, clinician-led national virtual MDT model that integrates local treating teams. Prospective evaluation is underway to examine adoption of MDT recommendations, preservation of radical intent, treatment trajectories, multidisciplinary interventions and patient outcomes.
Conclusions
A national virtual MDT provides a practical mechanism to reduce geographic inequity in access to specialist EOCRC expertise. This model extends beyond conventional single-institution MDTs by supporting longitudinal multidisciplinary care, repeated reassessment and national collaboration. Ongoing evaluation through the RIIO Registry will determine its impact on implementation of recommendations, treatment pathways and patient outcomes, and may provide a scalable framework for other complex cancer populations.