Improving National Bowel Screening participation through primary care engagement: a quality improvement report
John McMenamin
1 * , Susan Parry 2 , Bronwyn Rendle 2 , Cathy Whiteside 3
1
2
3
Abstract
The National Bowel Screening Programme (NBSP) in Aotearoa New Zealand aims to reduce bowel cancer mortality through early detection. Despite this, participation remains lower among Māori and Pacific peoples. In 2023 and 2024, primary care-led campaigns were introduced to support general practices to engage eligible patients in screening discussions.
General practices had varied levels of engagement with reminder systems and resources, and many lacked consistent processes for incorporating screening into routine consultations. To address this, tailored materials and practice support tools were provided.
Campaign participation included a substantial number of New Zealand practices, including engagement of Very Low-Cost Access (VLCA) clinics. Overall, the volume of faecal immunochemical test (FIT) kit requests more than doubled over 2 years; however, return rates remained modest, highlighting the need for additional follow-up strategies.
Future efforts should focus on expanding reminder systems, enhancing practice workflows, and incorporating outreach support to increase kit completion rates.
Structured primary care interventions can boost screening uptake, particularly among equity priority groups. Sustained improvements in screening participation will depend on system integration and continued support for practices and communities.
Keywords: Bowel cancer screening, FIT kit, health equity, Māori health, opportunistic screening, Pacific health, practice-based intervention, primary care.
References
1 Te Whatu Ora – Health New Zealand. National Bowel Screening Programme monitoring report: January 2018 to December 2022; 2023. Available at https://www.tewhatuora.govt.nz/assets/Publications/Bowel-screening/National-Bowel-Screening-Programme-Monitoring-Report-January-2018-to-December-2022.pdf
2 Te Whatu Ora – Health New Zealand. National Bowel Screening Programme monitoring report: January 2018 to December 2022; 2023. Available at https://www.tewhatuora.govt.nz/assets/Publications/Bowel-screening/National-Bowel-Screening-Programme-Monitoring-Report-January-2018-to-December-2022.pdf
3 Durkin SJ, Broun K, Spittal MJ, et al. Impact of a mass media campaign on participation rates in a National Bowel Cancer Screening Program: a field experiment. BMJ Open 2019; 9: e024267.
| Crossref | Google Scholar | PubMed |
4 Calanzani N, Cavers D, Vojt G, et al. Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable? A mixed-methods feasibility study in Scotland. BMJ Open 2017; 7: e016307.
| Crossref | Google Scholar | PubMed |
5 Adhikari K, Manalili K, Law J, et al. Interventions to increase colorectal cancer screening uptake in primary care: a systematic review. J Am Board Fam Med 2022; 35(4): 840-858.
| Crossref | Google Scholar | PubMed |
7 Whanganui District Health Board. A year of success in the fight against bowel cancer; 2020. Available at https://www.wdhb.org.nz/media-releases/a-year-of-success-in-the-fight-against-bowel-cancer/ [accessed 16 September 2024].
8 Health and Research Collaborative. National Bowel Screening Programme Primary Care Campaign (May 2023 - May 2024). Health and Research Collaborative. Available at https://www.harc.org.nz/research-project/national-bowel-screening-programme-primary-care-campaign-may-2023-may-2024 [accessed 30 September 2024].
