Poster Abstracts
Theme: Risk and Prevention
Abstract number 39
NON-ADHERENCE TO CORE DIETARY GUIDELINES TO REDUCE COLORECTAL CANCER RISK WAS HIGHER IN YOUNGER ADULTS UNDERGOING COLONOSCOPY SURVEILLANCE
Molla M Wassie, Meseret Derbew Molla, Jean M Winter, Norma Bulamu, Melkalem Azanaw, Erin L Symonds
Background: Early onset of colorectal cancer (CRC) is increasing in Australia. This increment is partly due to poor adherence for dietary guidelines, but the evidence is limited in young adults undergoing colonoscopy surveillance due to a family history of CRC or personal history of colorectal neoplasia.
Aim: To determine the dietary adherence to guidelines level for younger adults (aged <50 years) at increased risk of CRC as compared with older adults (age ≥50 years).
Method: Individuals participating in a structured colonoscopy surveillance in Southern Adelaide Health Network due to an increased risk of CRC in 2023-2024 completed the Australian Eating Survey. The adherence scores for six core diet components (vegetable, fruit, whole-grain, lean meat, dairy and alcohol consumption) were derived using the Australin Eating Guideline. The association between age of adults (younger vs older) and dietary adherences were examined using multivariable binary logistic regression after adjusting possible confounders. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported.
Results: Of 1917 participants that completed the survey, 149 (7.8%) were younger adults. Overall, the non-adherence rate was 72.2% for vegetables, 61.1% for fruits, 95.5% for whole-grain, 93.8% for lean meat, 82.7% for dairy and 22.8% for alcohol consumption. The odds of poor adherence to the Australian dietary guidelines were two times higher in younger adults for vegetables (AOR = 2.10; 95%CI, 1.34-3.40), 1.6 times higher for fruit (AOR = 1.60; 95%CI, 1.08-2.39) and two times higher for alcohol consumption (AOR = 2.10; 95%CI, 1.36-3.20) when compared with older adults. There was no age-related difference in adherence to other core food groups.
Conclusion: The odds of having poor dietary adherence to vegetables, fruits and alcohol consumption was higher in younger adults compared with the older adults. Dietary advice and education should be integrated in the prevention strategies of early onset CRC.
Abstract number 40
ASSOCIATION BETWEEN METABOLIC SYNDROME AND RISK OF COLORECTAL NEOPLASIA AMONG PEOPLE ALREADY AT ELEVATED RISK FOR COLORECTAL CANCER
Meseret Derbew Molla, Erin L Symonds, Jean M Winter, Charles Cock, Molla M Wassie
Background: Metabolic syndrome is associated with increased risk for colorectal cancer (CRC); however, its impact for individuals already at elevated risk for CRC due to prior polyps or a family history of CRC is not clear.
Aim: To assess the association between metabolic syndrome and colorectal neoplasia in individuals at elevated risk for CRC.
Methods: A retrospective study that collected data from the clinical database of people who are undergoing a surveillance colonoscopy procedure in South Australia from 24th February 2021 – 25th May 2024 were conducted. Metabolic syndrome was defined using the World Health Organization criteria, including type 2 diabetes plus at least two of the following metabolic factors: obesity, hypertension, and/or dyslipidemia. The association between metabolic syndrome and diagnosis of colorectal neoplasia at the follow-up colonoscopy were analysed using multivariable binary logistic regression. Sub-group analysis by sex were also conducted. Statistical significances were determined when the 95% confidence interval (CI) did not cross the null hypothesis.
Results: 2,806 participants with 1526 (54.4%) prevalence of colorectal neoplasia and 13.8% prevalence of metabolic syndrome were included. Metabolic syndrome (adjusted odds ratio (AOR) = 1.47; 95%CI, 1.10 – 1.99) was significantly associated with the odds of colorectal neoplasia. This risk of association remained significant in males (AOR = 1.74; 95%CI, 1.31 – 2.31) but not in females (AOR = 1.20; 95%CI, 0.87 – 1.66).
Conclusions: This study identified metabolic syndrome as a significant risk factor for colorectal neoplasia in male participants of individuals already at elevated risk for CRC. This finding supports the clinical guidelines to shorten colonoscopy surveillance intervals for male participants with metabolic syndrome.
Abstract number 41
TYPE 2 DIABETES AND ITS IMPACT ON TIME TO COLORECTAL CANCER DIAGNOSIS: A LINKED DATA STUDY USING GENERAL PRACTICE ELECTRONIC MEDICAL RECORD AND CANCER REGISTRY DATA.
Ji-Yun Lung, Allison Drosdowsky, Kylie Vuong
Introduction/Background: General practice has important responsibilities in cancer diagnosis and chronic conditions management. It is common for people living with cancer to have other chronic conditions. Colorectal cancer (CRC) was the third most common cancer in Victoria in 2023. Type 2 diabetes was ranked 12th for specific cause of disease burden in Australia in 2024. However, there is little evidence on how chronic conditions will impact the time to cancer diagnosis (TTD).
Objectives/Aims: In this study, we aim to assess the association between type 2 diabetes and its impact time to colorectal cancer diagnosis.
Description/Methods: This study used Data Connect, a linked general practice electronic medical record and cancer diagnosis data. Patients with type 2 diabetes were identified from the general practice data using medical history, encounters, and reason for prescriptions. Complexity in type 2 diabetes management was inferred by the numbers of diabetic medications prescribed. The cancer diagnostic interval started on the day of first presentation or clinical appearance and ended on the day of CRC diagnosis. Association between diabetes, complexity in diabetes management and TTD was examined using Cox Proportional Hazards model regression.
Results/Outcomes: There were 10358 CRC patients, TTD could be calculated for 982 patients, and 204 of them were identified with type 2 diabetes. There was no difference showed from the analysis of TTD and type 2 diabetes, which means that the patients with or without type 2 diabetes had similar TTDs (HR=0.97, p=0.74). The TTD was similar across the different levels of complexity in diabetes management (HR=1.01, p=0.87).
Conclusions: The study has showed that patients had similar TTD for CRC patients with and without type 2 diabetes and across the different levels in diabetes management, highlighting the strengths within general practice for comprehensive patient-centred care.
Theme: Screening and Early Detection
Abstract number 43
COLORECTAL CANCER SCREENING PARTICIPATION AND OUTCOMES IN A YOUNG COHORT AGED 40-49 YEARS
Erin L. Symonds, Geraldine Laven-Law, Renee J. Smith, Charles Cock, Molla M. Wassie, Graeme P Young
Introduction/Background: Until recently, colorectal cancer (CRC) screening through the National Bowel Cancer Screening Program (NBCSP) has been limited to ages 50-74y using faecal immunochemical tests (FIT). Guideline changes mean that younger individuals (45-49y) can now opt into the NBCSP, and those aged 40-44y can access FIT via the general practitioner. It is not clear what the participation may be in younger individuals, or what colonoscopy findings will be after a positive FIT.
Objectives/Aims: To determine FIT participation, positivity and colonoscopy findings in people aged 40-49y compared to older age groups.
Description/Methods: We analysed data from a colonoscopy surveillance program (2011-2019) in which individuals were sent two-sample FITs (EIKEN CHEMICAL CO., Japan) between colonoscopies, using the same brand and positivity threshold (≥20µg Hb/g faeces) as the NBCSP. Positive FIT results were followed up with colonoscopy, and outcomes were assessed for advanced neoplasia (CRC, advanced adenomas and high-risk serrated lesions). Statistical analyses were with Chi-square tests and logistic regression.
Results/Outcomes: FIT participation was 45.4% in the 40-49y age group (464/1424), significantly lower compared to older age groups of 54.0% in 50-59y (2517/4662), and 59.2% in 60-74y (5707/9640) (p<0.01). Participation in the 40-49y cohort was more likely with a higher socioeconomic status (odds ratio (OR) 1.05, 95%CI 1.01-1.09) and with previous FIT completion (OR 3.17, 95%CI 2.61-3.84). FIT positivity was lowest in the 40-49y group (40-49y: 4.8%, 50-59y: 7.5%, 60-74y: 10.3%, p<0.01). Likelihood of advanced neoplasia for those with a positive FIT result (n=750) was similar across age groups, with positive predictive values of 10.0% for 40-49y, 10.1% for 50-59y, and 12.7% for 60-74y (p>0.05).
Conclusions: FIT participation is lowest among those aged 40-49y, but likelihood of advanced neoplasia after positive FIT is comparable with older ages. Appropriate campaigns, such as early education, are needed to support CRC screening in these younger individuals.
Abstract number 44
PREDICTORS OF BOWEL CANCER SCREENING PARTICIPATION AMONG 45–49-YEAR-OLDS IN THE AUSTRALIAN NATIONAL BOWEL CANCER SCREENING PROGRAM
Sandra Sursock, Belinda Goodwin, Mark Jenkins, Sibel Saya, Carlene Wilson, Katelyn Collins, Lyn Buchanan, Tina Campbell, Jennifer McIntosh
Introduction: The Australian National Bowel Cancer Screening Program recently expanded to include adults aged 45–49. Participation rates in this newly eligible age group are currently unknown; however, among those aged 50–74, younger age is associated with lower participation (31% in ages 50–54 vs 50% in ages 70–74). Evidence from international screening programs also suggests that an opt-in approach is less effective than automatically mailing out kits. Identifying mechanisms that influence participation in younger adults is essential to inform targeted interventions to increase screening. Psychological theories, such as the Health Action Process Approach (HAPA), provide insight into the processes underlying health behaviour.
Objectives: To examine (1) associations between HAPA constructs (risk perception, positive outcome expectancies, negative outcome expectancies, action self-efficacy and planning) and perceived likelihood of screening participation, and (2) whether these associations differ by previous screening participation.
Methods: An online, anonymous survey was conducted with Australians aged 45–49. Hierarchical regression analyses examined associations between HAPA constructs and perceived likelihood of screening participation, adjusting for demographic characteristics. Separate interaction analyses assessed whether associations between HAPA constructs, and the perceived likelihood of screening participation differed by previous screening participation.
Results: The survey was completed by 685 participants. The final model accounted for 34% of the variation in perceived likelihood of screening participation. Higher risk perception, positive outcome expectancies, action self-efficacy and planning were associated with increased perceived likelihood of screening, whereas higher negative outcome expectancies were associated with lower perceived likelihood of screening participation. The influence of outcome expectancies, action self-efficacy and planning on perceived likelihood of screening participation was stronger among individuals who never screened.
Conclusion: Interventions that target HAPA constructs, such as highlighting benefits, increasing confidence through clear instructions and reducing barriers through practical solutions could be effective in increasing screening participation.
Abstract number 45
PROCESS EVALUATION OF A GP-LED INTERVENTION TO IMPROVE COLORECTAL CANCER SCREENING: INSIGHTS FROM THE MAIL, GP & SCALE TRIAL
Anna Kelly, Qingwei Luo, Joanna Jaques, Karen Canfell, Jie-Bin Lew, Lyndal Trevena, Sarah Durkin, Emily He, Belinda Goodwin, Mark Jenkins, Kate Broun, Katina D’Onise, Christopher Horn, Melissa Treby, Amanda McAtamney, Anita Dessaix, Jeff Cuff, Claire Nightingale, Glenn Austin, Paul Grogan, Natalie Taylor, Eleonora Feletto
Introduction: Efforts to improve participation in Australia’s National Bowel Cancer Screening Program (NBCSP) increasingly recognise the importance of engaging general practitioners (GP). GP-led activities depend on organisational and behavioural factors that influence the capacity to support colorectal cancer (CRC) screening. Variability in practice workflows, capability, and integration with the National Cancer Screening Register can constrain primary care activities. As part of the MAIL, GP & SCALE trial, a process evaluation examined organisational and behavioural mechanisms shaping general practice involvement in CRC screening through implementation of a GP-led intervention.
Aim: To examine how a GP-led intervention influenced practice readiness, staff engagement with NBCSP activities, and behavioural determinants.
Methods: GPs from four sites across Australia were randomised to intervention or usual care. The intervention comprised a decision support aid, point-of-care prompts, clinical information system enhancements, and education. Pre- and post-trial surveys were administered at two levels: (1) a practice level survey assessing organisational readiness, systems to support screening, and perceived enablers; and (2) staff level surveys assessing service processes and behavioural determinants related to screening support. Pre–post differences were compared across trial arm, site, and practice size.
Results: Eighty-three practices (41 intervention, 42 control) and 395 practice staff (GPs, nurses and practice managers) participated, with 81 practices completing surveys, and 293 practice staff completing individual surveys. Preliminary findings indicate that the intervention strengthened several organisational processes, including improved data-quality activities, more structured preventive-health promotion, and a more consistent focus on screening workflows. Early findings also suggest shifts in staff awareness, perceived capability, and confidence in engaging with NBCSP related tasks.
Conclusion: The process evaluation provides insights into the organisational and behavioural pathways through which GPled interventions can enhance NBCSP delivery in primary care. Findings will inform practical strategies to support sustainable, scalable interventions across Australian general practice to support cancer screening.
Abstract number 46
USING THE FAECAL IMMUNOCHEMICAL TEST TO IMPROVE COLONOSCOPY TRIAGE FOR PATIENTS PRESENTING WITH IRON DEFICIENCY IN PRIMARY CARE
Jennifer Pham, Geraldine Laven-Law, Rachel Parker, Esme Jasko, Jean Winter, Peter Bampton, Charles Cock, Erin Symonds
Introduction: Iron deficiency (ID) including ID with anaemia (IDA) can be caused by bleeding from colorectal cancer (CRC) and advanced pre-cancerous neoplasia, making ID/IDA a common referral for endoscopic investigations to rule out significant colonic pathology. Due to the high demands on endoscopic services, there is increasing interest in using faecal immunochemical tests (FIT) to triage ID/IDA presentations in primary care.
Aim: To assess the diagnostic performance of FIT for advanced colorectal neoplasia in patients with ID/IDA referred for colonoscopy in South Australia.
Methods: Adults (≥18y) referred for colonoscopy due to ID/IDA were prospectively invited to complete a two-sample FIT (EIKEN CHEMICAL CO, Japan) within 6 months before scheduled colonoscopy. Poor quality procedures were excluded from analysis unless advanced neoplasia was present. Advanced neoplasia included CRC and advanced pre-cancerous neoplasia (adenomas ≥10mm, with high-grade dysplasia or villous change, ≥5 adenomas, sessile serrated lesions ≥10mm and/or with dysplasia). Diagnostic utility of FIT was assessed at a positivity threshold ≥10 µg Hb/g faeces. Factors associated with advanced neoplasia were assessed using multivariable logistic regression analysis with odds ratio (OR) reported with 95% confidence intervals (CI).
Results: 247 ID/IDA individuals were included, with 56 (22.7%) aged <50y and 156 (63.2%) females. 51 individuals had advanced neoplasia (20.6%), including 8 (3.2%) with CRC and 43 (17.4%) with advanced pre-cancerous neoplasia. The FIT positivity rate was 30%. Using FIT as a triaging tool, 70% of colonoscopies could be avoided or delayed while detecting all cases of CRC and 46.5% of advanced pre-cancerous neoplasia. A positive FIT was the only factor associated with advanced colorectal neoplasia, independent of age and sex; OR 3.65 (95%CI 1.91–7.06, p<0.001).
Conclusions: A positive FIT is associated with the presence of advanced colorectal neoplasia. FIT can be an effective triaging strategy to prioritise ID/IDA presentations for colonoscopy in primary care.
Abstract number 47
ADVANCING EQUITY AND ACCESS IN EARLY BREAST CANCER DETECTION: CULTURALLY TAILORED RESOURCES FOR SOUTH ASIAN WOMEN IN VICTORIA, AUSTRALIA
Farwa Rizvi, Victoria White, Patricia Livingston, Kylee Bellingham, Sue-Anne McLachlan, Debbie Passey, Jennifer Philip
Background: Organisational and information gaps in culturally appropriate breast health information can contribute to inequities in breast cancer screening participation and missed opportunities for early detection. This study examined perspectives of South Asian (Pakistani and Indian) women, General Practitioners (GPs) and non-primary healthcare providers (HCPs) to inform organisation of care and development of targeted breast health information resource in Victoria.
Aim: Semi-structured interviews were conducted with 25 South Asian women (Pakistani and Indian; aged 35–65 years) and 15 healthcare providers including nine General Practitioners and six non-primary healthcare providers. Inductive and deductive thematic analysis was undertaken.
Results: Three major themes emerged: tailored breast health information, preferred formats for the breast health information resource, and community-based dissemination of information. South Asian women, General Practitioners and non-primary healthcare providers consistently highlighted the need for culturally and linguistically tailored breast health information to improve screening awareness and participation for early detection of breast cancer within the organisation of care. Participants prioritised resource features including concise one-page materials or short digital formats in Urdu and Hindi; visual explanations of the mammography (breast screening) procedure; reassurance regarding procedure-related pain, modesty, and the availability of female staff; and clear messaging that BreastScreen Victoria services are free. General Practitioners particularly emphasised the value of readily available, clinic-based resources to support proactive screening discussions with women. Both healthcare providers and women highlighted the importance of community-based dissemination through cultural centres, faith-based venues, ethnic media, and trusted community leaders. Digital materials were preferred by younger women, while print formats were favoured by older women.
Implications for practice/policy: Embedding culturally and linguistically tailored breast health information within routine primary care and community settings, supported by formal partnerships with community organisations and screening programs, may improve screening engagement and support early detection of breast cancer among culturally diverse populations.
Abstract number 48
RISK STRATIFICATION FOR SURVEILLANCE COLONOSCOPY WITH A COMBINED FAECAL HAEMOGLOBIN AND CALPROTECTIN TEST
Srishti Sharma, Geraldine Laven-Law, Rachel Parker, Alicia Dallisson, Rafha Rafeeu, Alex Barnes, Reme Mountifield, Charles Cock, Erin L Symonds
Background: Individuals with family history of colorectal cancer (CRC) or prior colorectal neoplasia are recommended regular surveillance colonoscopy. While this reduces CRC risk, it places a burden on healthcare resources due to low yield of clinically significant findings. Faecal haemoglobin (FHb) and calprotectin (FC) are non-invasive biomarkers for colorectal pathology which could be used to triage colonoscopy need, though there is limited evidence on the combined diagnostic performance.
Aim: To determine the diagnostic accuracy of the combined FHb/FC test for detecting advanced neoplasia in patients undergoing surveillance colonoscopy.
Methods: A prospective cohort of 1941 patients undergoing surveillance colonoscopy in southern Adelaide hospitals between 2023 and 2025 were invited. Participants completed a two-sample faecal immunochemical test (FIT) (EIKEN CHEMICAL CO., LTD, Japan) within 6 months before colonoscopy. Samples were analysed for FHb and FC. Colonoscopy outcomes of advanced neoplasia (CRC, advanced precancerous lesions) were collected, with the diagnostic performance of FHb/FC evaluated.
Results: 688 FITs with colonoscopy outcomes were included (median age 67.6y; 5.4% <50y; 46.9% male). Advanced neoplasia was detected in 15.7% (108/688, including 4 CRC). FHb levels ≥10 μg/g were present in 84 (12.2%) participants, with 36.9% (31/84) having advanced neoplasia diagnosed (including 3 CRC). Among FHb negative participants, 347/604 (57.5%) had elevated FC (≥50 μg/g), with 12.4% (43/347) having advanced neoplasia (including 1 CRC). The combined biomarkers were more specific for a younger cohort (<50y), with 49.3% (37/75) having either biomarker elevated with 48.6% (18/37) having advanced neoplasia, compared with the older cohort where 64.2% (394/614) had elevated biomarkers and 15.2% (60/394) had advanced neoplasia. A dual biomarker approach would reduce colonoscopies by 37.4% while detecting all CRC and 69.2% of advanced precancerous lesions.
Conclusion: Combined FHb/FC testing may support colonoscopy triage in surveillance populations, particularly in younger cohorts, allowing detection of advanced neoplasia while reducing unnecessary procedures.
Theme: Survivorship and Supportive Care
Abstract number 49
WHO PROVIDES PSYCHOSOCIAL CARE AFTER CANCER? A SCOPING REVIEW OF PRIMARY CARE ROLES, EXPERIENCES, AND SYSTEM ENABLERS
Michael Tran, Christina Signorelli, Carolyn Ee, Isabella Natale
Introduction/Background: Anxiety, depression, and fear of cancer recurrence, affect up to one‑third of people living with and beyond cancer. Yet many survivors report that these concerns remain insufficiently addressed. General practice is a key setting for psychosocial support across the cancer trajectory, as survivors frequently attend for diagnosis, treatment follow‑up and ongoing management. Despite this, cancer‑specific mental health programs are limited, care pathways are inconsistently defined, and responsibilities between oncology and primary care are often unclear. Survivors frequently describe assuming responsibility for coordinating their psychosocial care.
Objectives/Aims: This scoping review aimed to examine:
- Cancer survivors’ and carers’ mental health experiences within primary care,
- How GPs and primary care teams understand and enact psychosocial roles, and
- System‑, service‑, and patient‑level factors shaping effective mental health support across the cancer care continuum.
Description/Methods: Following PRISMA‑ScR guidelines, four databases (PubMed, Embase, CINAHL, PsycINFO) were searched to 25 February 2026. Of 1,734 records identified, 1,678 were screened, 42 full‑text articles reviewed, and 21 studies included. Data were narratively synthesised.
Results/Outcomes: Across diagnosis, treatment and survivorship, patients consistently sought relational fundamentals: being heard, clear plans, and reliable safety‑netting, especially during periods of diagnostic uncertainty or surveillance. Role ambiguity between oncology and primary care contributed to unmet psychosocial needs, inconsistent messaging, and anxiety. Many survivors acted as intermediaries between services, highlighting system gaps and inequities. Proactive primary care engagement, including nurse‑led psychoeducation and community nursing contact, enhanced self‑efficacy and fostered a valued sense of security. Effectiveness varied according to system‑level constraints (time, referral capacity), service‑level processes (communication, warm‑handoff pathways), and patient‑level factors (stigma, readiness, cultural safety, family impact).
Conclusions: Improving psychosocial survivorship care in primary care requires clearer role delineation between oncology and general practice. Timely, reliable communication pathways, structured follow‑up, and early nurse‑led or multidisciplinary team‑based interventions are strong enablers.
Abstract number 50
BRIDGING THE GAP: ENGAGING GPS IN THE LIFELONG CARE OF CHILDHOOD CANCER SURVIVORS
Kate Alford, Kerrie Graham, Melissa Treby
Background: Each year, approximately 1000 children and adolescents in Australia receive a cancer diagnosis.¹˒² Although survival rates have improved, the long-term consequences of survivorship remain poorly recognised and inadequately supported. Research shows that close to 80% of childhood and adolescent cancer survivors will develop at least one late effect – spanning physical, psychological, and social domains.³ As these survivors move out of paediatric specialist services, GPs often take on the role of primary clinician – yet only half of GPs report feeling equipped to manage this population, and nearly half of survivors struggle to find knowledgeable community-based providers.⁴
Aim: To build GP capacity in childhood cancer survivorship care in WA, through direct clinical observation, and establish a network of trained GPs able to provide coordinated care for survivors transitioning from paediatric services.
Methods: In partnership with the Paediatric Oncology Survivorship team at Perth Children’s Hospital (PCH), Cancer Council WA recruited GPs through its Primary Care Cancer Education project to attend supervised clinical attachments. Participants observed specialist clinicians and oncology nurses across the Transition Clinic and one additional specialist clinic (Leukaemia and Lymphoma, Brain Tumour, or Solid Tumour). Sessions included pre-clinic meetings, health surveillance consultations, and survivorship planning discussions.
Outcomes: Six GPs completed attachments between December 2023 and 2025. Evaluation data demonstrated consistently strong outcomes: 100% of participants rated the attachment as relevant to their practice, all learning outcomes were met, and 100% reported they would recommend the activity to a colleague and change something in their clinical practice.
Conclusions: Supervised clinical attachment is an effective and highly valued model for building GP expertise in childhood cancer survivorship. Administrative barriers and time constraints currently limit scale. Planned next steps include GP reimbursement, complementary online learning resources, and a referral network connecting transitioning survivors with trained community GPs.
Abstract number 51
“I’M HERE TOO!”: EXPLORING CANCER SURVIVORSHIP EXPERIENCES, NEEDS, AND PREFERENCES OF PEOPLE WITH INTELLECTUAL DISABILITY AND HEALTH PROFESSIONALS
Jennifer Baldock, Irene Belperio, Hannah Beinke, Tim Cahalan, Jala Burton, Michelle Bellon
Introduction/Background: People with intellectual disability face persistent inequities in cancer care, leading to poorer cancer‑related outcomes. There is a significant gap in understanding cancer survivorship experiences from the perspectives of people with intellectual disability and the health professionals who support them during cancer.
Objectives/Aims: Led by an inclusive research team, this study aimed to explore cancer survivorship experiences, needs, and preferences of people with intellectual disability and the health professionals who support them in Australia.
Description/Methods: This abstract reports findings from a larger phenomenological study exploring cancer survivorship for people with intellectual disability. Semi‑structured interviews and focus groups were conducted with people with intellectual disability with and without lived experience of cancer (n = 25), and health professionals with experience supporting people with intellectual disability and cancer (n = 17), including primary care and allied health disciplines. Data were analysed using reflexive thematic analysis.
Results/Outcomes: People with intellectual disability reported varied experiences across health and cancer care. Positive experiences involved being listened to, included in decisions, and supported with accessible language. Negative experiences included being dismissed, overwhelmed by information, excluded from discussions and decisions, and being given limited options. The importance of understanding cancer, treatment, and survivorship relating to everyday life, autonomy, and continuity of care was emphasised.
Health professionals recognised primary care and allied health as central to coordinating and supporting continuity of care for people with intellectual disability. However, they identified limited formal training, time constraints, and fragmented communication between primary, secondary, and tertiary services and between health and disability services as barriers. Care quality reportedly varied depending on clinician experience and service context.
Conclusions: Primary care plays a critical role in effective cancer survivorship care for people with intellectual disability. Integrated findings highlight the need for accessible communication, strengthened workforce capability, and improved service integration to support equitable, person‑centred cancer care.
Abstract number 52
OPTIMISING SUPPORTIVE CARE FOR FIRST NATIONS PEOPLES WITH HEAD AND NECK CANCER IN AUSTRALIA
Sneha Sethi, Joanne Hedges, Nic Reid, Lisa Jamieson
Background: Despite a 1.5 times increased disease burden of Head and Neck Cancers (HNC) for First Nations Peoples over the past two decades, there is a lack of research, support and culturally appropriate resources. This gap leads to low awareness, decreased screening, delayed diagnosis and poor prognosis.
Aim: This proposal aims to address this gap, following principles consistent with those specified in Cancer Australia’s National Aboriginal and Torres Strait Islander Cancer Framework. This project aims to (1) prepare a report on the national level disease burden of HNC among First Nations People; (2) facilitate the co-design process of designing culturally appropriate resources to identify early signs of HNC, promoting early detection and screening; and (3) facilitate the co-design of a culturally appropriate digital platform to support First Nations People with HNC.
Outcomes: Reinforcing engagement, involvement and leadership by First Nations People throughout the development, design and delivery of the outcomes for this project. This project focuses on empowering Communities, by placing ownership in the hands of community elders, leaders and youth to help identify and guide the path to achieve sustainable, acceptable and culturally secure outcomes.
Conclusion: Research project address epidemiological and supportive care aspects of HNC for First Nations People, including robust data reports, pre-diagnosis screening awareness and post diagnosis supportive care.
Abstract number 53
MEASURING THE IMPACT OF COMMUNITY SUPPORT GROUPS IN CANCER PATIENTS AND THEIR FAMILIES IN A MULTI-CULTURAL SETTING: A COST-BENEFITS APPROACH
Shivani Sivapalan, Ramya Walsan, Ashfaq Chauhan, Virginia Mumford, Reema Harrison
Introduction: Cancer survivors from culturally and linguistically diverse (CALD) backgrounds experience poorer health outcomes and barriers to accessing supportive care. Community organisations can address these disparities by delivering culturally tailored psychosocial and supportive services. Sister Cancer Support Group (SCSG), based in Wollongong, Australia, provides peer-led support programs for CALD women affected by cancer.
Objectives/Aims: To evaluate the organisational costs of delivering SCSG programs and assess their impact on multicultural community members affected by cancer using a cost-benefit analysis (CBA) framework.
Description/Methods: A mixed-methods study design was conducted. A preliminary literature review informed development of a program logic model. Data was collected through semi-structured interviews with consumers and volunteers and review of organisational annual reports. Costs were analysed using basic counting principles and rebased to the 2025–2026 financial year using a 5% discount rate. A sensitivity analysis was conducted to test the robustness of cost estimates.
Results/Outcomes: Annual organisational costs comprised $10,700 in capital expenditure, $14,080 in recurrent costs, and $300 in regulatory expenses. Twenty-two participants were interviewed, including 11 volunteers and 11 consumers. Nine non-English home languages were represented. Consumer engagement was sustained, with 45.5% participating for 2–4 years and 27.3% for ≥6 years. Attendance was consistent, with 54.5% attending ≥20 sessions and 27.3% attending 10–20 sessions. All consumers recommended the program, reporting improved health literacy, psychosocial wellbeing, and community connectedness with minimal travel burden. All volunteers had contributed for ≥2 years, with 77.7% reporting ≤10 hours of monthly involvement.
Conclusions: SCSG represents a low-cost, community-based model delivering multidimensional benefits for CALD cancer survivors. Sustained engagement and positive perceived outcomes highlight the value of culturally tailored community organisations in addressing inequities in supportive cancer care and support investment in similar programs.
Abstract number 54
A QUALITATIVE STUDY OF CANCER CLINICAL TRIAL GROUPS’ CONSUMERS’ ACCEPTANCE OF THE MODULAR APPROACH TO PATIENT-REPORTED OUTCOME MEASUREMENT: HOW MUCH OF IT IS “COMMON SENSE”?
Carrie-Anne Ng, Mariana Sousa, Tiffany Patterson, Brendan Mulhern, Jessica Roydhouse, Tim Luckett
Background: There is growing interest in customising patient-reported outcome measures (PROMs) by selecting key health-related quality of life (HRQoL) domains (i.e., subscales) most relevant to a study’s context and omitting others – called the ‘modular approach’. The modular approach has become the focus of much attention for key stakeholders in the field of PROMs but is not yet widely implemented in cancer clinical trials.
Aim: To explore the acceptability of the modular approach from the perspectives of consumer representatives (patients, family members and/or caregivers) involved with the Australian and New Zealand Cancer Cooperative Trials Groups (CCTGs).
Methods: A qualitative approach was taken using online focus groups. Participants were recruited through the CCTGs. Analysis was guided by Sekhon et al.’s Theoretical Framework of Acceptability.
Results: Ten consumers participated across four focus groups. Four themes emerged regarding acceptability of the modular approach: (1) minimising respondent burden is not simply about shortening PROMs; (2) competing priorities of reducing burden, preserving PROM integrity and assessing breadth versus depth of issues; (3) new strategies are needed to improve PROM relevance; and (4) who should select the domains, and how? Consumers valued the modular approach for increasing question relevance, minimising duplication, and allowing for more in-depth assessment of priority HRQoL issues. They also supported involving consumer representatives in domain selection to alleviate the burden on researchers during trial design.
Conclusions: CCTG consumer representatives were generally supportive of using the modular approach in administering PROMs in cancer clinical trials, while also noting the need for clearer consensus and guidance on what constitutes a well-justified selection of domains. The Cancer Quality of Life Expert Service Team (CQUEST) invites PC4 investigators to discuss PROMs and/or subscale selection to ensure trial objectives are directly addressed while considering participant burden and yielding results that are optimally informative for stakeholder needs.
Theme: Systems and People
Abstract number 55
ADVANCING IMPLEMENTATION OF SHARED CARE FOR CANCER SURVIVORS USING A SYSTEMS-THINKING APPROACH (THE SEAMLESS STUDY)
Ria Joseph, Fiona Crawford-Williams, Imogen Ramsey, Chad Y. Han, Oluwaseyifunmi A. Agbejule, Carolyn Ee, Michael Jefford, Adam G. Elshaug, Jon Emery, Bogda Koczwara, Lillian Leigh, Vivienne Milch, Raymond J. Chan
Introduction/Background: Systems thinking helps explain complex problems by examining how different parts of a system interact and shape outcomes over time. Although interest in this approach is growing, it has not yet been applied to shared care, and there is limited evidence on broader system‑level factors influencing its implementation beyond local site‑specific barriers and facilitators.
Objectives/Aims: The aims of this study were to (1) understand the interactions between system-level factors and key leverage points impacting the implementation of shared care models in Australia and (2) develop strategies and actions targeting these leverage points.
Description/Methods: A systems thinking approach was applied through two facilitated workshops (online and face-to-face) using group model building and the nominal group technique to guide discussions.
Results/Outcomes: Twenty-four stakeholders participated in either one or both workshops (18 in workshop one and 15 in workshop two), including patient advocates (n = 4), oncology specialists (n = 3), primary care providers (i.e., general practitioners (GPs) and practice nurses) (n = 5), oncology nursing professionals (n = 6), cancer care researchers (n = 3), and policymakers (n = 3). A causal loop diagram was developed following workshop one, informed by stakeholder discussions and existing literature. In workshop two, stakeholders prioritised 10 key leverage points in terms of importance, with the top three being (i) funding and resource allocation; (ii) healthcare interoperability, health information exchange, and information technology; and (iii) collaborative relationships. In response to these prioritised leverage points, stakeholders identified 12 potential strategies and 55 corresponding actions to address the challenges.
Conclusions: A systems thinking lens enabled stakeholders to prioritise key leverage points and develop targeted strategies to enhance shared care implementation. These strategies can be used to address key areas for change in policy planning and practice in Australia.
Abstract number 56
UNDERSTANDING HOW A SYSTEMS‑CHANGE INTERVENTION IMPROVED DELIVERY OF SMOKING CESSATION CARE IN ANTENATAL PRIMARY CARE: A MEDIATOR ANALYSIS FROM THE MOHMQUIT TRIAL
Larisa A J Barnes, Jo Longman, Megan Passey
Background: Smoking during pregnancy remains a major preventable cause of adverse maternal and infant outcomes. While clinical guidelines recommend routine cessation support in antenatal care, implementation in practice remains inconsistent. MOHMQuit (Midwives and Obstetricians Helping Mothers to Quit smoking), was a theory‑informed systems‑change intervention designed to address behavioural and organisational barriers influencing antenatal health professionals (midwives, obstetricians and Aboriginal Health Workers) provision of cessation support.
Objectives: To explore whether MOHMQuit influenced key barriers to health professional behaviour change by modifying mediators related to capability, prioritisation, and organisational context within maternity services.
Methods: MOHMQuit was implemented using a cluster‑randomised stepped‑wedge design across eight public maternity services in New South Wales. Health professionals completed questionnaires pre‑training and six months post‑training assessing eight pre‑specified mediators derived from the Behaviour Change Wheel and Theoretical Domains Framework. Changes in mediator scores were analysed using regression analyses accounting for clustering and repeated measures. Semi‑structured interviews with maternity service leaders (n=19) were conducted six months post‑implementation examine organisational processes and contextual influences relevant to the mediators. Quantitative and qualitative findings were triangulated.
Results: Survey data were analysed from 229 health professionals pre‑training and 80 at six months post‑training. Significant improvements were observed across 17/22 mediator items, including all capability‑related items and most work environment items. No significant change was observed for perceived effectiveness of Quitline referral or discomfort discussing smoking. Leader interviews provided contextual explanations for observed changes, highlighting the role of leadership engagement, training quality, workflow integration, resource availability, alignment with service policies.
Conclusions: The MOHMQuit intervention influenced multiple behavioural and organisational mediators relevant to delivery of smoking cessation care in antenatal settings. Examining mechanisms of change alongside contextual factors offers practical insights into how theory‑informed systems‑change interventions can support implementation of evidence‑based care in routine antenatal primary care.
Abstract number 57
EMBEDDING GUIDELINE‑RECOMMENDED SMOKING CESSATION SUPPORT INTO ROUTINE ANTENATAL CARE: SYSTEMS‑CHANGE OUTCOMES AND ECONOMIC VALUE FROM THE MOHMQUIT (MIDWIVES AND OBSTETRICIANS HELPING MOTHERS QUIT SMOKING) TRIAL
Larisa A J Barnes, Alison Pearce, Daniel Barker, Ashleigh Stuart, Jo Longman, Megan Passey
Background: Despite mandated clinical guidelines, smoking cessation support is not consistently delivered during antenatal care. MOHMQuit was a co‑designed, theory‑informed systems‑change intervention targeting workforce and organisational barriers to improve routine delivery of cessation support in public maternity services.
Objectives: To evaluate the impact of a primary care-led, systems‑change intervention on delivery of cessation support, smoking outcomes, and the economic value of investing in organisational change.
Methods: A pragmatic stepped‑wedge cluster‑randomised controlled trial was conducted across eight public maternity services in New South Wales to enable clinicians to deliver cessation care within routine antenatal workflows. Data were drawn from electronic medical records (EMR), clinician surveys (pre‑intervention and six months post‑intervention), and postpartum interviews with women. Smoking outcomes included biochemically verified and self‑reported abstinence at the end of pregnancy. Economic evaluation estimated within‑trial cost‑effectiveness and modelled lifetime costs, health outcomes, and return on investment from a health-system perspective.
Results: EMR-documented behavioural cessation support increased from 5.6% pre‑intervention to 19% post‑intervention (OR 3.73; 95% CI 2.76–5.05). Clinician survey results showed significant improvements in advice, assistance, and overall cessation support six months after training. Women’s recall of receiving cessation support did not significantly change. Biochemically verified abstinence did not differ significantly in intention‑to‑treat analyses but a statistically significant increase in biochemically verified abstinence was observed post‑intervention in as‑treated complete‑case analyses (OR 2.36; 95% CI 1.04–5.36). The within‑trial incremental cost per additional quitter was $1,635, and lifetime modelling suggested the intervention was cost‑saving, generating a return of $6.67 for every dollar invested.
Conclusions: A systems‑change intervention embedded within routine antenatal primary care improved delivery of smoking cessation support and demonstrated potential economic value, even where cessation effects were modest. These findings highlight the importance of investment in organisational capability and implementation strategies to address evidence–practice gaps in maternity care.
Abstract number 58
THE CHANGING LANDSCAPE OF AUSTRALIAN PSYCHO-ONCOLOGY CLINICAL TRIALS: A SCOPING REVIEW
Kirsty Galpin, Haryana Dhillon, Lisa Beatty, Brian Kelly, Thomas Carlick, Laura Kirsten, Amanda Hutchinson, Joanne Shaw
Background: Despite the significance of psycho-oncology’s contribution to cancer care and improving outcomes, it is challenging to obtain funding for psycho-oncology research. Increasing participation in cancer clinical trials is a priority under the Australian Cancer Plan.
Aims: This scoping review mapped Australian psycho-oncology clinical trials registered between 2006 and 2024, examining study designs, populations, sample sizes, interventions, and settings.
Methods: The Australian New Zealand Clinical Trials Registry (ANZCTR) was systematically searched for psycho-oncology trials. Included trials involved interventions such as psychological therapies, psychoeducation, communication, supportive care, and system-level strategies targeting cancer patients, caregivers, or healthcare professionals (HCPs) in Australia. Of 779 protocols retrieved, 152 were eligible. Following PRISMA for Scoping Reviews guidelines, data were extracted using double extraction and narratively synthesised.
Results: Registered protocols increased over time. Half (49%, n=75) the studies were completed, 22% (n=34) recruiting, 18% (n=28) not recruiting, and 10% (n=15) stopped early/withdrawn, most were pilot studies. Participant cohorts were predominantly mixed gender (87%, n=132), 12% (n=18) female-only, 1% (n=2) male-only. Populations included patients/survivors (n=109; of which n=7 were advanced cancer), carers 7% (n=10), HCPs 3% (n=5); 18% (n=28) trials included >1 participant group. Most studies were in adults (≥18 years; 87%). Median target sample size was 100 (range 4–9600). Of studies reporting final recruitment (n=75), 47% (n=35) met or were within 20% of target. Psychological therapies were most prevalent (42%, n=66) and exercise trials increased 24%. Online interventions rose from 12.5% to 43% over time.
Conclusions: Registered psycho-oncology clinical trials have increased over time, shifting from face-to-face to digital/online delivery. Interventions increasingly incorporate exercise and target diverse populations, including caregivers and HCPs. However, recruitment challenges persist, with few studies meeting sample targets, likely compounded by structural funding constraints. Systematic registration remains critical for monitoring trends, informing funding, and supporting research aligned with evolving care models.