Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Understanding implementation of a multicomponent colorectal cancer screening intervention in Australian general practice  (146581)

Eleonora Feletto 1 , Anna M Kelly 1 , Karen Canfell 1 , Jie-Bin Lew 1 , Lyndal Trevena 2 , Sarah Durkin 3 4 , Emily He 1 , Belinda Goodwin 5 , Mark Jenkins 6 , Kate Broun 7 , Katina D'Onise 8 , Christopher Horn 9 , Melissa Treby 10 , Amanda McAtamney 11 , Anita Dessaix 12 , Jeff Cuff 13 , Claire Nightingale 6 , Zhicheng Li 14 , Glenn Austin 15 , Paul Grogan 1 , Natalie Taylor 14 , Qingwei Luo 16
  1. Cancer Elimination Collaboration, Sydney School of Public Health, The University of Sydney, Newtown, New South Wales, Australia
  2. The University of Sydney, Camperdown, New South Wales
  3. Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria
  4. Australia School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria
  5. Cancer Council Queensland, Fortitude Valley, Queensland
  6. Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Victoria
  7. Cancer Council Victoria, Melbourne, Victoria
  8. School of Public Health, The University of Adelaide, Adelaide, South Australia
  9. Cancer Institute NSW, St Leonards, New South Wales
  10. Cancer Council Western Australia, Perth, Western Australia
  11. Cancer Council Australia, Sydney, New South Wales
  12. Cancer Council NSW, Woolloomooloo, New South Wales
  13. Research Advocate, Sydney, New South Wales
  14. School of Population Health, The University of New South Wales, Sydney, New South Wales
  15. Queensland Health, Brisbane, Queensland
  16. The Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, New South Wales

Aims: To examine implementation of a multicomponent colorectal cancer screening intervention in Australian general practice, including changes in practice systems and perceived implementability.

Methods: A process evaluation was conducted alongside the MAIL, GP & SCALE cluster-randomised hybrid type 2 effectiveness-implementation trial across four Primary Health Network sites. The intervention included a decision-support tool, electronic point-of-care prompts, National Cancer Screening Register (NCSR) integration, education, and implementation support from Clinical Trial Coordinators. Practice-level surveys assessed organisational readiness, screening systems and perceived enablers. Implementation surveys assessed perceived ease of implementation across intervention components.

Results: Eighty-three practices participated in the trial, including 41 intervention and 42 usual care practices. Practice-level survey data were available from 81 practices. Across all participating practices, the likelihood of taking an active focus on bowel cancer screening (OR 11.18, 95% CI 4.33-28.91, p<0.0001) and having a workflow to manage and monitor bowel cancer screening (OR 5.13, 95% CI 2.34-11.24, p<0.0001) increased from baseline to follow-up. Among intervention practices, 40/41 completed the implementation survey. Perceived ease of implementation differed across intervention components. Electronic reminder prompts were rated slightly easier to implement after the trial (83.3% vs 85.0%), whereas the decision-support tool (82.4% vs 67.5%), NCSR integration (83.3% vs 77.5%) and education (82.9% vs 65.0%) were rated as less easy to implement following delivery. These findings are based on staff perceptions; objective measures of intervention uptake and adoption are forthcoming.

Conclusions: Practices reported stronger organisational focus on bowel cancer screening and more established screening workflows at follow-up than at baseline. Within intervention practices, perceptions of implementability varied across components, with electronic reminder prompts appearing most readily integrated into routine practice. These findings suggest that strengthening screening systems and workflows is achievable in general practice, although some intervention components may require additional support to facilitate implementation and long-term sustainability.