Oral Abstracts
Session 1: Comprehensive Cancer Care: Equity, Access and Whole of Systems
Abstract number 01
FROM EVIDENCE TO IMPLEMENTATION: PRIMARY CARE ACROSS THE CANCER CONTINUUM
Prof Vivienne Milch
Background: General Practitioners (GPs) are trusted providers of holistic and continuous care. As often the first point of contact for people navigating cancer risk or symptoms, and through their ongoing involvement in care across the cancer continuum, GPs are uniquely positioned to translate evidence into practice and improve outcomes for people affected by cancer.
Aim: To highlight how primary care enables the translation of evidence-based national cancer reform initiatives into practice.
Methods: Cancer Australia has a key role in developing evidence-based national strategies to improve cancer outcomes, experiences and equity. However, achieving impact relies on the support of primary care to embed evidence-based policy within everyday healthcare delivery across the care continuum.
Outcomes: As the main entry point to healthcare for most Australians, GPs are key enablers of personalised prevention and early detection, an objective of both the Australian Cancer Plan and The National Framework for Genomics in Cancer Control. The success of risk-stratified screening and genomics-informed care relies on primary care to improve patient health literacy and support informed decision-making in a person-centred and culturally safe manner. Recognising their critical role, the National Lung Cancer Screening Program was designed with GPs at the centre of the screening pathway. The program relies on primary care to identify eligible participants, support informed decision-making, communicate results and coordinate follow-up care.
GPs also have an important role in investigating signs and symptoms of cancer, initiating timely and appropriate investigations, and referring to specialist services. The National Optimal Care Pathways Framework and contemporary updates to the Optimal Care Pathways provide evidence-based guidance to support earlier diagnosis, with successful implementation dependent on integration into primary care.
Across treatment, survivorship and follow-up care, GPs provide continuity, coordination and holistic support. The Australian Comprehensive Cancer Network promotes connections between primary and specialist care around the country, supporting integrated and person-centred care to improve experiences and outcomes for people affected by cancer.
Conclusion: Primary care serves as the interface where evidence-based national policy can be translated into sustainable, real-world improvements in cancer care. Ongoing investment in primary care capability, engagement and partnerships will be essential to improving outcomes and experiences for people affected by cancer.
Abstract number 02
DEATH AND THE COMEDIAN – THE CANCER FINISHING SCHOOL
Dr Peter Goldsworthy
Peter Goldsworthy is now on his fourth different chemotherapy regimen since a bone marrow transplant for his myeloma in 2019.
His memoir, The Cancer Finishing School (Penguin, 2024), tells the story of his treatment. The subtext, obliquely, of the typically ironic title is this: what lessons might cancer teach him before it finishes him off?
A GP of 40 years practice as well as one of Australia’s most awarded and celebrated writers, he brings his characteristic black humour and story-telling power to the tale of his cancer journey.
Interspersed with his story are numerous odd and astonishing Oliver Sacks-like stories of his own patients – both cautionary tales and exemplary tales, sometimes laugh-out-loud, sometimes deeply moving, sometimes tragically stupid, which intersect with, or refract, his own travels through denial, anger and acceptance.
Also woven through this tapestry are anecdotes about literary friends who have trodden similar illness paths – Oliver Sacks himself, Clive James, Joan Didion, Gwen Harwood, John Coetzee, and Les Murray among them – which add depth and richness to what might otherwise be just another doctor’s story about his own cancer – albeit one that is both darkly funny and filled with love and wonder.
Hs most recent book of poems, Tomorrow (Pitt St Poets, 2026) also explores these themes. As did his recent performance of stand-up comedy at the Adelaide Cabaret Festival.
Abstract number 03
FROM PATHWAY TO PERSON: THE PATIENT TEST FOR COMPREHENSIVE CANCER CARE
Karen van Gorp
Cancer care is described as a continuum, but patients experience it as a series of challenging thresholds: waiting for answers, managing side effects, and living with uncertainty. This presentation offers a consumer advocate’s perspective on why primary care is central to comprehensive cancer care. Drawing on the lived experience of stage IV melanoma survivorship, it asks a vital question: does cancer care work for the person at home, between appointments, when they are tired and trying to live their life?
General practice, allied health, and community care are critical across the cancer journey. They support early detection, manage treatment effects, and provide psychosocial care. Yet, patients and families still carry the burden of navigating a fragmented system.
Primary care cancer research is vital because it examines care outside specialist centres, where evidence must translate into real life. It addresses the questions that matter most to consumers: Who knows my whole story? Who helps me understand what comes next? Who supports my family?
This presentation argues that consumer partnership is essential to designing usable interventions and measuring outcomes that reflect what people can actually access, trust, and use. Clinical evidence shows what can work; primary care makes it work in daily life; consumers show whether it truly matters.
Abstract number 04
STRENGTHENING CONNECTED CANCER CARE NETWORKS THROUGHOUT SOUTH AUSTRALIA
A/Prof Michael Osborn
Australia achieves excellent cancer survival outcomes, however opportunities remain to improve patient-centred outcomes, quality of life, treatment experience, equity and value.
Consequently, the South Australian Comprehensive Cancer Network (SACCaN) has been established as the state’s peak cancer network, bringing together clinicians, researchers, policymakers, community organisations and people affected by cancer. Rather than investing in a single comprehensive cancer centre, South Australia has adopted a statewide, decentralised comprehensive cancer network model funded over four years through the Australian Government and The Hospital Research Foundation Group. SACCaN is integrated within SA Health and aligned with the South Australian Cancer Plan, Australian Cancer Plan, and Cancer Australia’s vision for a nationally connected cancer system.
Over four years, SACCaN is making strategic investments across priority areas:
Cancer Data and Intelligence: Development of a statewide cancer data ecosystem, including an integrated linked cancer data spine. This will support clinical decision-making, service benchmarking, quality improvement, research and health system planning. The initiative also supports implementation and monitoring of Cancer Australia’s Optimal Care Pathways.
Clinical Trials: SACCaN aims to make clinical trials routine and accessible for all eligible South Australians. Priorities include streamlining ethics/governance processes, strengthening teletrials, expanding early-phase trial access, and developing tools to help clinicians identify and refer patients to available studies.
Patient Experience and Navigation: SACCaN is partnering with various organisations to improve cancer care navigation, supportive care and survivorship services, and are supporting research in these areas.
Workforce Sustainability: Statewide surveys identified significant burnout and retention concerns among cancer nurses. In response, SACCaN is implementing a Cancer Workforce Wellness and Sustainability Program focused on work redesign, team support and cultural change.
Prevention and Equity: SACCaN is partnering with Cancer Council SA and Aboriginal health organisations to deliver targeted prevention and early-diagnosis initiatives, particularly for Aboriginal people, culturally and linguistically diverse communities, socioeconomically disadvantaged groups, and regional populations.
In addition, SACCaN is investing in infrastructure and statewide cancer service planning to meet future demand. Its overarching goal is to create an enduring, connected cancer network that improves equity, quality, patient experience, research participation, workforce sustainability and outcomes for all South Australians affected by cancer.
Abstract number 05
PERSPECTIVES FROM HEALTHCARE PROVIDERS AND SOUTH ASIAN WOMEN ON IMPROVING BREAST CANCER SCREENING IN VICTORIA AUSTRALIA
Farwa Rizvi, Victoria White, Patricia Livingston, Kylee Bellingham, Sue-Anne McLachlan, Debbie Passey, Jennifer Philip
Background: Participation in breast cancer screening among culturally diverse communities including South Asian women in Australia remains below national targets. General Practitioners (GPs) and non-primary healthcare providers (HCPs) play a pivotal role in bridging communication, cultural, and organisational gaps for under-screened communities.
Aims: To explore (1) strategies used by GPs and non-primary HCPs to promote screening for early breast cancer detection among South Asian women aged 35–70 years, and (2) women’s perspectives on what constitutes acceptable and appropriate preventative care.
Methods: Semi-structured interviews were conducted with 40 participants (25 South Asian women and 15 HCPs including nine GPs) in Victoria. Participants were recruited via purposive and snowball sampling via community organisations, primary care practices, specialist networks and peer-to-peer referrals. Data were analysed using reflexive thematic analysis.
Results: Three overarching themes were identified across both groups: trust and health behaviour, communication strategies, and cultural competency. Trust in GPs and HCPs helped address fear, stigma, and misconceptions influencing screening participation. GPs and non-primary HCPs emphasised clear explanations, visual aids, and culturally tailored discussions. Women highlighted the importance of reassurance to support informed decision-making for both routine (asymptomatic) and diagnostic (symptomatic) screening. Both groups identified a need for linguistically appropriate resources and suggested multilingual text message reminders to improve awareness of free screening services. Culturally safe environments, including access to female staff, confidentiality, personalised care, and ongoing cultural competency training, were considered essential. Existing breast health communication resources were viewed as insufficient to meet South Asian women’s needs. Conclusion: Improving breast cancer screening participation among culturally diverse communities requires policy support for culturally competent, trust-based care across primary and specialist settings. Embedding co-designed multilingual resources, reminder systems, and culturally safe service features (including female staff) within organised screening pathways and BreastScreen programs may enhance equitable access, engagement, and early detection.
Abstract number 06
RECRUITMENT OF CULTURALLY AND LINGUISTICALLY DIVERSE POPULATIONS IN PRIMARY CARE-BASED CLINICAL RESEARCH: A REALIST REVIEW
Sophie Chima, Georgia Ramsay, Yuhang Zhang, Kylie Vuong, Matthew Thoenig, Christy Vu, Audra de Witt, Janelle Jones, Jon Emery, Sibel Saya
Background: Representation of culturally and linguistically diverse (CALD) populations in research focused on chronic disease prevention and management is vital. However, CALD populations are often underrepresented in primary care-based clinical research, leading to health inequities and limiting the ability to meet the needs of people seeking health care. A variety of strategies are utilised by researchers to maximise engagement with target populations and increase recruitment into clinical research, with tailoring of different approaches for different population groups and health topics.
Aim: We conducted a realist review, with a systematic approach, of primary care-based clinical research involving CALD populations to explain what strategies targeting CALD populations are effective at improving recruitment into primary care-based clinical research, and under what circumstances.
Method: We searched MEDLINE, EMBASE, CINAHL and CENTRAL for relevant studies between November 2004 and November 2024. A realist synthesis was conducted to examine how specific recruitment strategies (mechanisms) interact with cultural, linguistic, and socioeconomic factors (contexts) to improve research participation and representation
Results: We identified 44 relevant studies. Five core themes emerged: (1) trust-building, (2) accessibility enhancement, (3) community engagement and partnership, (4) cultural adaptation and relevance, and (5) practical support and burden reduction. Mechanisms for improving recruitment included the use of culturally appropriate recruiters and community partnerships; language support and flexible study designs; and culturally adapted interventions and materials. These mechanisms were supported in contexts where there was strong community engagement, cultural competence among research staff, and alignment with CALD community values.
Conclusion: This review highlights the recruitment strategies that utilise the unique characteristics of primary care. These strategies will likely inform future studies on increasing CALD participation in primary care clinical research. Future research should focus on developing and evaluating context-specific, culturally tailored recruitment strategies.
Abstract number 07
SHARED FOLLOW-UP CARE MODEL BETWEEN CANCER SPECIALISTS AND GENERAL PRACTITIONERS FOR CANCER SURVIVORS: A PROGRAMMATIC APPROACH TO DEVELOPMENT, PROGRESS AND STRATEGIES GOING FORWARD
Raymond J. Chan
Background: Current follow-up care for cancer in Australia is mostly oncology-led and focus on surveillance for disease recurrence, rather than holistic care needs. This does not capitalise on the expertise of general practitioners (GPs). The evidence and policy suggesting the benefits of shared follow-up care between cancer specialists and GPs are clear. However, a wide-scale implementation of this shared-care model has not yet occurred in Australia.
Objectives: Describe the development, progress and strategies for implementing a Nurse-Enabled Shared Follow-Up Care Model for Cancer Survivors
Methods: We describe the development and characteristics of five PC4-supported randomised controlled trials (RCTs) on shared care. EMINENT and GOSPEL were single-centre, phase II pilot RCTs enrolling 61 women with early breast cancer and 49 people with lymphoma respectively. IBIS was a multi-centre pragmatic stepped-wedge cluster randomised trial enrolling 631 women with early breast cancer. MOSES and AUSNET are multi-centre hybrid type II RCTs that have enrolled 174 and 178 participants with early prostate cancer and neuro-endocrine tumours respectively to date (actively recruiting).
Results: A nurse-enabled, shared follow-up care model was developed with extensive input from consumers and a range of health care professionals and researchers including GPs, cancer clinicians, biostatisticians, implementation scientists, and health economists through (1) one-on-one consumer meetings, (2) structured reviews from the PC4 Consumer Advisory Group and methodology experts, (3) PC4-hosted concept development workshops, (4) qualitative studies, systems thinking studies, and discrete choice experiments. A number of implementation learnings have emerged, which can be used to inform subsequent efforts to enhance shared-care implementation.
Discussion: Learnings from the development of the model of care and implementation efforts enable reflection and determination of strategies for implementation in primary care going forward. Clinician researchers and leaders should continually consider efforts that can advance the shared-care agenda through implementation at provider, organisation and policy levels.
Abstract number 08
STRENGTHENING GENERAL PRACTICE’S ROLE IN COLORECTAL CANCER PREVENTION: THE REFER4SCOPE TOOL AND EDUCATION PROGRAM
Eleonora Feletto, Anna Kelly, Joanna Jaques, Emily He, Karen Canfell, Lauren Lee, Tara Bowman, Christopher Horn
Background: Primary care plays a critical role in colorectal cancer detection through risk assessment, referral, and support of National Bowel Cancer Screening Program participation. Colonoscopy remains the key diagnostic test for individuals at above average risk; however, rising demand across Australia is placing pressure on timely access. Ensuring appropriate referral from primary care, aligned with guideline recommended pathways, is essential to reduce unnecessary procedures, improve triage efficiency, and support equitable cancer care.
Aim: To co-design and implement a decision-support tool and accredited education module to strengthen general practice capability in assessing, triaging, and referring patients for colonoscopy services in New South Wales (NSW).
Methods: We developed Refer4Scope, an interactive web-based decision-support tool, and an education module, co-designed with end-users and informed by the 2023 Clinical Practice Guidelines f and the 2020 NSW Colonoscopy Categorisation Guide. Refer4Scope was programmed in R, and the module was accredited by the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM).
Results: Refer4Scope is available at www.cancer.nsw.gov.au/refer4scope. The module was delivered in June 2025, and converted into short-form videos and case studies for flexible, on-demand access. The resources integrate guideline-based referrals into routine practice based on Faecal Occult Blood Test results, symptoms, and family history. Feedback indicates that Refer4Scope is practical and valuable for supporting evidence-based decision-making in primary care. Since launch, more than 1,000 users have accessed the tool, with an average session duration of nearly three minutes. Statewide dissemination is ongoing and with planned updated to improve Refer4Scope’s useability.
Conclusions: This co-designed, scalable model demonstrates how primary care–centred digital tools and education can accelerate guideline adoption, streamline referral pathways, reduce unnecessary colonoscopies, and improve patient access to timely diagnostic care, providing a template for other cancer pathways.
Abstract number 09
IMPROVING EQUITY AND ACCESS TO SKIN CANCER CARE IN RURAL AUSTRALIA: THE RISE4SKINCANCER INTEGRATED CARE MODEL
Leigh Kinsman, Dr Tom Dewar, Ms Cheryl Martin
Introduction/Background: Rural Australians experience higher skin cancer incidence, poorer outcomes and reduced access to timely diagnosis and treatment compared to metropolitan populations. In Victoria’s Loddon Mallee region (LMR), melanoma incidence is higher than the state average, with increased environmental risk factors and barriers to care including workforce shortages, fragmented systems and longer distances to access health services. Strong local intersectoral collaboration and innovation saw a regional Victorian consortium form, to successfully secure $2.8 million of Commonwealth funding for five years of collaborative, systemic and equitable skin cancer service improvements and treatment redesign across the LMR.
Objectives/Aims: To design, implement and evaluate a regionally integrated model that improves equitable access to timely, optimal skin cancer diagnosis, treatment and care.
Description/Methods: RISE4SkinCancer is a five-year, multidisciplinary, codesigned program integrating consumers, primary, community and specialist care services. Key program components include: (1) primary care workforce education, decision support and practice enhancements; (2) locally tailored clinical pathways and referrals supported by integrated technology systems and artificial intelligence; (3) co-designed, culturally appropriate health literacy resources; (4) First Nations-led model of care. Implementation is guided by the Knowledge-to-Action framework, with ongoing stakeholder and consumer engagement. A prospective, cluster non-randomised design is comparing the integrated model to usual care, evaluating timely and appropriate access, patient quality of life, cost-effectiveness and practitioner satisfaction with education and support.
Results/Outcomes: The first year of codesign has identified barriers, including limited local services, unclear referral pathways, need for practitioner education and support, and inconsistent consumer health literacy. The model prioritises delivering care closer to home, improving diagnostic accuracy, practitioner and practice support and strengthening service coordination.
Conclusions: RISE4SkinCancer aims to address structural inequities in rural care by embedding integrated, locally tailored solutions, to improve access, reduce delays, and enhance outcomes for underserved populations, with scalable interventions for equitable skin cancer care appropriate for other regional settings.
Abstract number 10
STAKEHOLDER-IDENTIFIED ISSUES IN PRIMARY CARE MANAGEMENT OF MULTIMORBIDITY IN CANCER: CONSULTATION WITH AUSTRALIAN CONSUMERS AND HEALTHCARE PROFESSIONALS TO INFORM A CLINICAL PATHWAY
Emma Kemp, Monique Bareham, Sharon Lawn, Richard Reed, Lisa Beatty, Katia Ferrar, Raechel Damarell, Jackie Roseleur, Bogda Koczwara
Introduction: Multimorbidity (co-occurrence of two or more chronic conditions) is common in cancer survivors, impacts all stages of cancer care, increases prognosis uncertainty and care complexity, and is associated with adverse outcomes. While primary care is integral to chronic disease management in the general population and shared care is recommended in cancer survivorship, fragmentation between tertiary and primary care is frequently experienced.
Aims: This presentation reports Australian stakeholder experiences and recommendations to inform the role of primary care within a clinical pathway for managing multimorbidity in cancer survivors.
Methods: Adult cancer survivors with multimorbidity, caregivers and healthcare professionals involved in cancer and multimorbidity care participated in qualitative semi-structured focus groups or interviews. Reflexive thematic analysis was used to identify key themes relating to primary care involvement in managing multimorbidity in cancer, including potential points for integration into a clinical pathway.
Results: Survivors and caregivers (n=30) and healthcare professionals (n=24) identified that multimorbidity in cancer requires a person-centred, biopsychosocial approach with continuity of care from diagnosis to post-treatment, ideally supported by primary care involvement. Barriers to effective engagement included poor communication across care settings, limited survivor access to primary care, and challenges related to confidence and trust from survivor and healthcare professional perspectives. Despite challenges, stakeholders reported positive multimorbidity management experiences involving general practitioners, pharmacists, and practice nurses. Facilitators included primary and other healthcare professionals actively championing communication, and survivor trust developed through responsive relationships with primary care professionals. To address the needs of survivors with multimorbidity, a clinical pathway should include sustained engagement with primary care and opportunities to embed primary care expertise in cancer care settings.
Conclusions: Effective long-term multimorbidity management in cancer requires sustained engagement with primary care, ideally from point of diagnosis. Increasing meaningful primary care involvement will require implementation-focused research, supportive policy reform, and appropriate resourcing.
Session 2: Emerging Technologies and Approaches
Abstract number 11
UPDATING THE AARHUS STATEMENT: INTERNATIONAL CONSENSUS ON GUIDELINES FOR EARLY CANCER DIAGNOSIS RESEARCH IN PRIMARY CARE
Rebecca Bergin, Allison Drosdowsky, Meena Rafiq, Aarhus update International Expert Working Group, Jon Emery
Introduction/background: Timely cancer detection and treatment is a key health system priority, with much interest in reducing delays in primary care. The Aarhus statement is the premier guideline for designing early cancer diagnosis research, but it was published over a decade ago.
Objectives/aims: To develop international consensus on updates required to the Aarhus statement to better serve primary care research, policy and practice.
Description/methods: Modified Delphi methodology involving international expert working groups (including primary care clinicians), anonymous online survey rounds, and patient and public involvement (PPI). Consensus was defined as ≥70% agreement. Round 1 items were developed through expert engagement; Round 2 included items not reaching consensus and new items from free-text comments. PPI representatives reviewed items with continued lack of consensus.
Results/Outcomes: Forty-six people completed Round 1 and 34 completed Round 2. Respondents came from diverse settings (e.g. UK, Australia, Ireland, Spain, Canada, Mexico, Singapore, Denmark), most were researchers (>95%) and/or clinicians (35 – 43%), and over half had >10 years’ experience. In Round 1, 23 of 33 items (70%) reached consensus, including: recognition of multiple diagnostic routes – symptomatic, screening and incidental presentations (87 – 100% agreement); specific analytic considerations (74% agreement); and renaming the ‘pre-treatment interval’ (78% agreement). In Round 2, consensus was reached on reporting standards for the timing of investigations and including emergency presentations (both 77% agreement). PPI representatives affirmed that the ‘patient interval’ name should be changed and the non-linear nature of pathways should be explicitly described.
Conclusions: Through international consensus, key elements for updating the Aarhus statement were identified. These changes better reflect international variation in health systems and routes to diagnosis, including through primary care. The updated statement will support consistency and quality of primary care cancer research, generate robust evidence to inform policy and practice, and support earlier cancer detection and better outcomes.
Abstract number 12
A CIRCULATING TUMOUR DNA BLOOD TEST TO IDENTIFY PATIENTS WITH SYMPTOMS OF COLORECTAL CANCER WHO REQUIRE PRIORITISED COLONOSCOPY REFERRAL
Jean M. Winter, Geraldine Laven-Law, Rafha Rafeeu, Rachel Parker, Renee J. Smith, Charles Cock, Erin L. Symonds.
Introduction/Background: Colorectal cancer (CRC) is common in Australia, with young-onset CRC (<50yrs) rapidly rising. CRC symptoms include rectal bleeding, iron deficiency anaemia, and bowel habit changes, but these are commonly reported in the general population. In Australia, investigations of these symptoms lead to many low-yield colonoscopies, as there is currently no guideline-recommended test to identify which patients would benefit from colonoscopy. We have developed a blood test that detects circulating tumour DNA (ctDNA) methylated for BCAT1 and IKZF1, which is accurate for CRC detection, but it’s utility in patients with symptoms of CRC has not been assessed.
Objectives/Aims: Determine the accuracy of ctDNA for detection of CRC in symptomatic patients.
Description/Methods: We prospectively enrolled individuals aged >18yrs who were referred to colonoscopy by their primary care provider for CRC symptoms. A blood sample was collected prior to colonoscopy and plasma (4.5 mL) was analysed for ctDNA using bisulphite conversion methylation-specific qPCR for BCAT1 and IKZF1, in which detection of any PCR signal was deemed positive. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CRC were calculated.
Results/Outcomes: 567 patients aged 18-94yrs were included (55.9% female), with 49 (8.6%) testing positive for ctDNA and 21 (3.7%) diagnosed with CRC. Sensitivity for CRC was 76.2% (16/21 CRC cases ctDNA positive), specificity was 94.0% (513/546 non-CRC cases ctDNA negative), PPV was 32.6% and NPV 99.0%. When analysing accuracy in young-onset cases of CRC (n=225), the positivity rate was 2.7%, sensitivity was 75.0% (3/4 CRC cases were ctDNA positive), specificity was 98.6% (218/221 non-CRC cases were ctDNA negative), PPV was 50.3%, and NPV was 99.5%.
Conclusions: Methylated BCAT1/IKZF1 ctDNA is accurate for identifying high-risk patients with CRC symptoms for prioritised colonoscopy, particularly in younger adults. Future studies using ctDNA to guide referrals in primary care are needed.
Abstract number 13
ADOPTION OF LUNG CANCER SCREENING RECRUITMENT STRATEGIES IN PRIMARY CARE: EARLY IMPLEMENTATION FINDINGS FROM THE READY TO SCREEN TRIAL AND ANALYSIS OF NATIONAL LUNG CANCER SCREENING PROGRAM PUBLICLY AVAILABLE DATA
Kartal D, Franchini, F. Lantin RM, Paul C, Bartlett G, Verbunt E, Emery JD, Tse J, Bonevski B, Dodd RH, Vinod SK, Brims F, McCullough S, Abraham S, Rhee J, Brooke M, Norris S, Marshall HM, Stone E, Barker D, Rankin NM
Background: Australia’s National Lung Cancer Screening Program (NLCSP) aims to improve early detection among high-risk populations. Impact depends on GP practices adopting recruitment strategies and integrating screening into routine care. However, little is known about how variations across Australian primary care or effects on large-scale implementation.
Aim: To examine adoption of lung cancer screening recruitment strategies and identify practice and system factors influencing implementation.
Method: The Ready to Screen cluster randomised implementation trial evaluated strategies to identify and engage potentially eligible patients (N~1700) across 38 metropolitan and regional GP practices in Victoria and NSW. Strategies included personalised invitations, co-designed brochures, multilingual posters, and a website. Mixed methods approach combined recruitment records, delivery documentation, staff surveys, and semi-structured provider interviews. Practice-level engagement was assessed through characteristics and provider participation in training, implementation activities, surveys and interviews. Outcomes included acceptability, appropriateness, feasibility, organisational readiness and implementation support. To contextualise findings, Medicare Benefits Schedule (MBS) data for low-dose CT (LDCT) screening claims were extracted from Services Australia Medicare Statistics. Uptake was calculated against state-specific eligible population estimates from published literature. Victorian LDCT provider and lung nodule clinic locations were mapped against local government area to assess geographic access.
Results: Recruitment strategies were perceived acceptable and appropriate, while feasibility varied by practice capacity to integrate strategies into workflow. Practices with higher engagement reported strong organisational readiness and provider confidence. Barriers included limited reimbursement, competing priorities, and resource constraints. Nationally, 64,000 screening LDCTs were claimed in the first 8 months of the NLCSP, including 16,890 in Victoria. Monthly claims remained stable (2,000-2,400) equating to ~12.5% uptake among Victorian eligible population. Geographic variation in service availability suggested inequities in access.
Conclusion: Effective implementation requires practice-level support addressing variations in capacity, geography and service infrastructure. Strengthening service integration will be critical to achieving participation among eligible population.
Abstract number 14
CONSUMER OPINIONS OF A NOVEL POINT-OF-CARE FAECAL IMMUNOCHEMICAL TEST FOR COLORECTAL CANCER SCREENING
Alicia K. Dallisson, Geraldine Laven-Law, Robert Le Blanc, Graeme P. Young, Charles Cock, Erin L. Symonds
Introduction: Colorectal cancer (CRC) screening using the faecal immunochemical test (FIT) reduces cancer incidence and mortality. However, participation rates are suboptimal (41.7%), with barriers including faecal aversion and unfamiliarity with the test. A newly developed point-of-care FIT (POC-FIT) using a different methodology to the standard FIT may address these barriers and increase participation.
Aim: To evaluate the end-user experience of the POC-FIT.
Methods: Consumers (n=207, 18-74y) were invited to complete the POC-FIT and a questionnaire assessing user experience. The POC-FIT involved applying a sample of toilet bowl water after a bowel motion to a rapid antigen test (RAT) cassette, with result lines appearing within 10 minutes. Test useability, acceptability and preferences were assessed from the questionnaire responses, with deductive content analysis applied against known screening participation barriers of test familiarity and faecal aversion.
Results: 62.8% (n=130/207) of consumers completed the POC-FIT and questionnaire, 60.8% were female, 65.4% of screening age (≥50y) and 68.5% with prior screening experience. 69.4% (n=59/85) of consumers with prior screening experience preferred the POC-FIT while 4.7% (n=4/85) preferred other CRC screening tests. Reasons for POC-FIT preference included it was easier, cleaner and quicker with 14.9% mentioning the lack of direct faecal sampling (n=13/87). 96.9% (n=126/130) of consumers were confident they completed the test correctly, 95.2% (n=119/125) were satisfied with an immediate RAT result, and 99.2% (123/124) were comfortable to follow-up their result with a doctor. 23.1% of consumers (n=25/108) mentioned familiarity with the SARS-Cov-2 RAT as why they found the test easy or satisfying. Of the screening aged consumers (≥50y) with no prior screening experience, 10.8% participated for the first time when offered the new test.
Conclusions: The POC-FIT was well-received by consumers and may increase participation by addressing existing barriers to CRC screening with a novel sampling method and familiarity of the RAT.
Abstract number 15
SMARTVOICE: ENHANCING THE AUSTRALIAN NATIONAL BOWEL CANCER SCREENING DIAGNOSTIC FOLLOW-UP WITH CONVERSATIONAL VOICE AI
Sandra Sursock, Lyn Buchanan, Sibel Saya, Tina Campbell, Mark Jenkins, Jennifer McIntosh
Background : The Australian National Bowel Cancer Screening Program (NBCSP) aims to reduce bowel cancer incidence and mortality. Its effectiveness depends on timely diagnostic follow-up of positive screening results. In 2023, 14.1% of individuals with a positive screening result did not complete follow-up despite the state-funded ‘Participant Follow-Up Function’ (PFUF) phone outreach service. The PFUF is a resource intensive service and does not successfully reach all individuals. Digital tools including conversational voice AI (CVAI) have demonstrated effectiveness at increasing screening uptake internationally and has the potential to augment PFUF processes. A prior study with PFUF teams in two Australian states explored their requirements and perspectives on integrating CVAI. Understanding the perspectives of using CVAI with people going through the PFUF processes is the critical next step.
Objectives: To explore (1) experiences of individuals receiving a positive NBCSP screening result, and (2) their perspectives on integrating CVAI into PFUF processes.
Methods: Semi-structured interviews will be conducted with participants contacted by PFUF from two Australian states (n=30). Inductive analysis will be used to understand peoples’ experience after testing positive for the NBCSP and if and how CVAI might complement their PFUF journey.
Results: Preliminary analysis of 15 interviews suggests that participants highly value PFUF interactions, appreciate the support and reassurance following a positive result. Previous colonoscopies and interaction with AI technology both positively and negatively influenced perceptions on CVAI. CVAI was potentially promising for providing information, including understanding next steps and explaining what a positive result meant. General consensus was that complex queries remained best addressed by the PFUF. Some participants raised ethical concerns about the type and detail of information they would share with the CVAI.
Conclusions: CVAI could enhance NBCSP diagnostic follow-up by serving as an additional resource to complement the PFUF by addressing straightforward queries and providing information.
Abstract number 16
POLYGENIC RISK SCORES AND BLOOD TESTS FOR THE EARLIER DIAGNOSIS OF CANCER IN PEOPLE PRESENTING WITH SYMPTOMS TO GENERAL PRACTICE: AN AUSTRALIAN LINKED DATA STUDY
Allison Drosdowsky, Sibel Saya, Silja Schrader, Cate Dellow, Larissa Popowski, Bethany Gilham, Roger Milne, Robert MacInnis, Jon Emery, Meena Rafiq
Background: Most cancer pathways in Australia start in general practice when a patient presents with a symptom. Diagnosing these cancers earlier requires evidence-based guidelines to help general practitioners (GPs) determine which symptomatic patients are at an increased risk of cancer. Using genomic risk information, such as polygenic risk scores (PRS), to assist with this is an emerging research area, however there is limited evidence on their utility in symptomatic patients.
Aim: To determine the utility of PRS in predicting two-year incidence of four cancers (breast, colorectal, melanoma and prostate) in symptomatic patients presenting to general practice and their added predictive value alongside commonly ordered blood tests.
Methods: A linked dataset was created containing PRS information from the Melbourne Collaborative Cohort Study (MCCS), general practice electronic medical record data from the PATRON repository, and cancer diagnoses from the Victorian Cancer Registry. Diagnostic prediction models using multivariate Cox proportional hazards regression were developed separately for each cancer type, with an outcome of cancer diagnosis within two years. Covariates were selected a priori. Internal validation was performed using bootstrapping.
Results: Cohorts ranged in size from n=70 (breast) to n=740 (colorectal). PRS had added predictive value for detecting cancer within two years in people presenting with symptoms of colorectal and prostate cancers but not breast cancer or melanoma. Of the blood tests considered, only prostate specific antigen (PSA) was predictive for prostate cancer, while multiple blood tests were predictive for colorectal cancer. PRS had added predictive value even after consideration of the blood test results.
Conclusion: PRS enhance the assessment of colorectal and prostate cancer risk in symptomatic patients in general practice. This is in addition to commonly ordered blood tests, suggesting genomic information could be a helpful addition to factors considered in current triage and referral pathways.
Abstract number 17
ROSELLA: KEY STAKEHOLDERS’ VIEWS ON IMPLEMENTING GENOMIC RISK-STRATIFICATION INTO SCREENING FOR AUSTRALIA’S MOST COMMON CANCERS.
Georgia Ramsay, Matthew Thoenig, Jon Emery, Sibel Saya
Background: Risk-stratified cancer screening has been identified as a priority in the Australian Cancer Plan, where individual risks are incorporated into personalised screening algorithms. Genomic risk factors are likely to play a part in population risk assessment in the future, alongside existing considerations including age, sex and family history of cancer.
Aim: To explore the path towards implementation of risk-stratified cancer screening using genomics in Australia.
Methods: A wide range of stakeholders (policymakers, academics, informed community members and advocates, peak body representatives, and clinicians) participated in semi-structured interviews. A breadth of implementation considerations was explored, including current views on risk-stratified screening, suggestions for optimal programs, equity, privacy, data storage and access, workforce considerations, and how gaps in the current evidence can be filled.
Results: 22 interviews have been conducted, and data collection and analysis are ongoing. The Australian context of existing screening programs and infrastructure provided opportunities and challenges for implementing future risk-stratified approaches. A balanced view was taken on the level of local evidence required prior to major program changes or initiation. Equity was a crucial consideration, with concerns about the lack of representative genomic data for all Australians, particularly First Nations Australians. Use of existing data infrastructure, such as the National Cancer Screening Register, or development of new, genomics-specific record infrastructure was suggested. Primary care was identified as a key setting for risk assessment, with participants highlighting the lessons from previous screening program changes and implementation that could inform this major shift in cancer risk assessment and screening delivery.
Conclusions: Participants identified the growing evidence behind risk-stratified cancer screening and were positive about its implementation. This study provides key areas for future research, as well as policy and implementation considerations for this major shift in delivery of cancer risk assessment and screening.
Abstract number 18
PRIMARY CARE–LED EARLY DETECTION OF SKIN CANCER: THE VALUE OF DERMOSCOPY TRAINING IN AUSTRALIA
Nikki McCaffrey, Clement Wong, Clover Maitland, Shannon Jones, Stephanie Cowdery, Emma Glassenbury, Rowan Purtell, Morton Rawlin, Edward Upjohn, Aleksandra Natora, April Murphy, Louisa Collins
Introduction: Skin cancer incidence in Australia is among the highest, with suspicious lesions often first presenting in primary care. However, diagnostic uncertainty can drive high referral and biopsy rates. Dermoscopy can improve diagnostic accuracy, reduce unnecessary specialist referrals, and promote earlier melanoma detection. While international evidence suggests dermoscopy training is cost‑effective in primary care, the longer‑term economic impacts are unknown.
Aim: The aim of this analysis was to evaluate the cost effectiveness of a dermoscopy training program for primary-care providers (PCPs) to improve diagnostic accuracy compared with visual inspection alone (VI) for the detection and management of suspected skin cancers in Australia.
Methods: A cost-effectiveness analysis was conducted from a societal perspective, accounting for costs and outcomes across the health system and society, using a decision tree linked to a Markov model with a 30-year time horizon. Model inputs were sourced from the literature, including a systematic review of dermoscopy training effectiveness, published health service data, and the Cancer Council Victoria Dermoscopy for Victorian General Practice Training Program. Outcomes included the incremental cost per quality-adjusted life-year (QALY) gained, and the number of undetected melanomas and keratinocyte cancers (KC).
Results: The modelled analysis estimated that dermoscopy-trained PCPs missed 3.6 fewer melanomas and 32.3 fewer KCs over 30 years compared with VI, per 1,000 patient encounters. Total costs were lower for dermoscopy training than VI ($9,669,238 vs $9,710,961), while QALYs were higher (18,080 vs 18,065), indicating dermoscopy training was the dominant strategy, albeit with small gains and savings.
Conclusions: The analysis suggests the incremental cost-effectiveness ratio for dermoscopy training for PCPs is below the often cited Australian threshold of A$50,000 per QALY gained, indicating value for money. These findings support sustained investment in dermoscopy training as a cost-effective skin cancer prevention strategy in primary care, particularly in high incidence settings like Australia.
Abstract number 19
THE PARTNER NETWORK: ENABLING EQUITABLE ACCESS TO PRIMARY CARE RESEARCH
Lushington, H., Harte, S., Gonzalez, D., Kirke, A., Radford, J., Stocks, N., Schofield, Z., Wallis, K., Sanci, L., Emery, J.
Introduction: The PARTNER Network is a national rural practice-based research network (PBRN) designed to strengthen primary care research across Australia by connecting regional, rural and remote general practices with clinical trials. By supporting practices to become research-ready and leveraging data-driven infrastructure, the program enhances access to clinical trials for underrepresented populations. Funded through the Medical Research Future Fund and administered by Queensland Health, the program contributes to the infrastructure goals of the Australian Teletrial Program, including delivery of 37 teletrial sites by 2027.
Aim: PARTNER aims to develop a sustainable national network for rural primary care research by improving equitable access to clinical trials and strengthening research capacity across regional, rural, and remote communities.
Method: The PARTNER Network was established through a collaboration between the University of Melbourne, University of Tasmania, University of Queensland, University of Western Australia, University of Adelaide, and the Royal Flying Doctor Service. Academic leaders from each institution form the executive team, working in partnership with a national advisory committee and a national community advisory group. Together, these groups have guided the network’s development, identified strategic opportunities, addressed implementation challenges, and supported the establishment of a sustainable clinical trials pipeline.
Results: PARTNER coordinators have recruited 112 GP clinics across five states and one territory, focusing on MMM2–7 communities. To date, 30 clinical trials have been approved, with rural patients enrolled in 10 trials across 31 practices. Opportunities include partnerships with rural medical schools, improved trial awareness and access, integration with other PBRNs, standardised governance, and GP education. Challenges include manual processes, geographic barriers, electronic medical record compatibility, workforce constraints, and privacy legislation compliance.
Conclusion: As Australia’s first national rural PBRN, the PARTNER Network offers a scalable model to enhance equitable research access, strengthen rural research capacity, and improve health outcomes for all Australians.
Session 3: Patients: Achieving the best outcomes for all Australians with cancer
Abstract number 20
OPTIMISING FEAR OF CANCER RECURRENCE SUPPORT FOR CHINESE-SPEAKING PEOPLE WITH CANCER: THE ROLE OF PRIMARY CARE
Verena Shuwen Wu, Allan ‘Ben’ Smith, Jing Liu, Eric Yeung, Cindy Sim Yee Tan, Ash Malalasekera, Chad Han, Heather Shepherd, Joanne Shaw, Laura Kirsten, Jia Liu, Suzanne Grant, Carolyn Ee
Introduction/Background: Fear of cancer recurrence (FCR) is one of the most common unmet needs, affecting up to 67% of people from culturally and linguistically diverse backgrounds. In response to this need, a clinical pathway was developed to assist with FCR identification and management. Community engagement is vital to ensuring that patient and health provider perspectives are integrated in pathway adaptations.
Aim: In partnership with CanRevive (Australia’s largest support organisation for Chinese-speaking families affected by cancer), this research aimed to identify culturally specific barriers and enablers to equitable implementation of the clinical pathway, and guide culturally appropriate adaptations/implementation strategies for Chinese-speaking people.
Methods: Qualitative interviews and focus groups informed by the Health Equity Implementation Framework (HEIF) were conducted by a bilingual Chinese-background researcher to identify implementation determinants and factors contributing to health disparities. Multiple perspectives were sought from Chinese-speaking survivors (n=10), caregivers (n=5), healthcare professionals (n=10), and community stakeholders (n=5). Directed content analysis guided by the HEIF was performed on transcripts, coded independently by two researchers.
Results: Implementation determinants were identified including: 1) culturally relevant factors of recipients (e.g., health literacy); 2) patient-provider interactions (e.g., role of primary care, communication of FCR treatment options); and 3) societal context (e.g., local availability of in-language resources). Primary care providers such as general practitioners were identified by Chinese-speaking survivors and caregivers as playing a key role in delivering FCR support. Identification of these determinants will inform pathway adaptations required to aid equitable implementation in practice.
Conclusions: Findings will contribute to improved supportive and survivorship care in a multicultural context that serves a high proportion of people from Chinese-speaking backgrounds. By integrating community engagement in the adaptation process, we will optimise clinical pathway implementation to identify and manage FCR in this priority population by supporting Chinese-speaking people’s preferences for FCR support from primary care providers.
Abstract number 21
TAILORING A PRIMARY CARE-BASED CANCER CLINICAL TRIAL FOR THE CHINESE COMMUNITY
Yuhang Zhang, Joyce Jiang, Janelle Jones, Dorothy Yiu, Wing Yee Siu, Carolyn Ee, Jon Emery, Sibel Saya
Background: Risk-stratified cancer screening has the potential to enhance cost-effectiveness and prevent more deaths from cancer. In primary care, translational research to implement this approach is underway. However, culturally and linguistically diverse (CALD) communities are underrepresented in this research, due to language barriers and access. This limits generalisability and external validity, particularly in a diverse society such as Australia’s. To ensure equitable implementation, interventions should incorporate cultural norms and needs of local CALD communities.
Aim: The CASSOWARY trial is the first Australian trial to test the clinical utility of a multi-cancer risk assessment in general practice. We aimed to develop adaptations to the recruitment methods and the intervention, to increase suitability to the Chinese community in Victoria, as one of our largest CALD communities.
Method: We used mixed-methods to develop strategies to improve awareness, involvement, and access to primary care-based clinical trials for the Chinese community. It included a quantitative evaluation of a community information session using pre- and post-session surveys, alongside focus groups exploring participants’ understanding and interpretation of clinical trials in general and the CASSOWARY trial methods and intervention within this cultural and social context.
Results: Survey findings identified a lack of knowledge about clinical trials as the primary barrier to participation, followed by language accessibility and safety concerns. GP endorsement was the most important facilitator, with transparency of research motivation and accessible Q&A opportunities also considered important factors. Focus group results will be presented at the conference, as analysis is ongoing.
Future directions: The results will be used to inform the adaptation of the CASSOWARY trial protocol to the Chinese community in Victoria, prior to piloting. This study will also be used to gain insight for primary care researchers to support the design of future primary care clinical trials, to optimise the inclusion of CALD populations.
Abstract number 22
ALLEVIATING ANXIETY AND AVOIDANCE OF CANCER SCREENING TESTS: A SYSTEMATIC REVIEW OF INTERVENTION STUDIES
Katelyn Collins, Hayley Fung, Emma Pearse, Xanthia Bourdaniotis, Belinda Goodwin
Background: Anxiety and avoidance can deter participation in life-saving cancer screening tests. This review is the first of its kind to examine and synthesise the evidence regarding the effectiveness of interventions aiming to alleviate these emotional barriers and enhance screening participation.
Methods: Electronic databases (APA PsycINFO, CINAHL, PubMed, and Web of Science) were systematically searched to identify studies published since 2015 that test the effect of interventions on screening-related anxiety and avoidance. Intervention effects on anxiety/avoidance and screening (e.g., intention, participation) were extracted. Author descriptions of the intervention components were coded according to the Behaviour Change Technique Ontology (BCTO) to identify core behaviour change techniques. Descriptive trends regarding intervention effectiveness by characteristic (i.e., delivery modality, target cancer type, behaviour change techniques) were explored.
Results: Twenty unique interventions met inclusion criteria, most (70%) of which had no effect on screening-related anxiety. Fourteen of the 20 included studies tested the effect of an intervention on screening outcomes, of which 68% demonstrated no effect. Most interventions, irrespective of their effectiveness, utilised didactic behaviour change techniques such as education about the benefits of screening or the risks of cancer. Five interventions were shown to reduce state anxiety and avoidance tendencies. These more successful interventions tended to pair informational support with concrete demonstrations of the screening process, as well as strategies to directly address patients’ emotional responses.
Conclusion: Recent trials suggest that interventions reliant on rational persuasion or education appear insufficient to alleviate screening-related anxiety. In primary care settings, providers have a key opportunity to “demystify” the screening procedure through practical demonstration or step-by-step instructions, as well as to normalise anxiety as a common screening barrier. Future research should aim to clarify the mechanisms underlying effective intervention strategies, thereby informing how primary care providers can discuss and address screening-related anxiety and maximise uptake.
Abstract number 23
RoBiN: AN ACCEPTABILITY AND FEASIBILITY STUDY OF PERSONALISED SCREENING WITHIN AUSTRALIA’S NATIONAL BREAST SCREENING PROGRAM
Anna Withanage Dona, Jon Emery, Sibel Saya, John Hopper, Jennifer Stone, Daniel Lee, Sue Malta, Helen Frazer, Erika Spaeth Tuff, Justin Tse, Sally Doncovio, Sue Macaulay, Cindy Schultz Ferguson, Nikki Davis, Madeline Luke, Georgia Ramsay
Introduction/Background: Breast cancer is the most diagnosed cancer in Australian’s aged 40 to 59. However, the risk varies widely across individuals in the population, which has been a major factor contributing to this ongoing challenge. Multifactorial risk assessments which incorporate both clinical and genomic breast cancer risk factors could provide a systematic approach to identify those at increased risk, improve resource allocation and determine appropriate referrals. RoBiN is the first Australian-based study to pilot a personalised risk-based approach within the national breast screening program.
Objectives/Aims: The primary objective of the RoBiN study is to evaluate the acceptability and feasibility of offering risk-based screening recommendations. The secondary objectives of this study will determine the psychosocial impact (i.e. cancer-specific anxiety, risk perception) of the intervention which includes a multifactorial breast cancer risk assessment and a risk report containing personalised screening recommendations.
Description/Methods: Women aged 40-59 attending a scheduled mammogram at BreastScreen Victoria were sequentially approached. DNA was collected using an oral swab to calculate a breast cancer polygenic risk score (PRS). The BRISK model (incorporating the PRS, breast density, family history, height, weight and menopausal status) was used to calculate 10-year and lifetime risk of developing breast cancer and tailor supplemental screening. Participants and their nominated general practitioner were provided a risk report containing personalised risk information and screening recommendations.
Results/Outcomes: This approach recruited 150 women (63% accrual) in a 12-week period and identified 35 high risk individuals (23.3% of the cohort) who were eligible for a Medicare funded MRI (unpublished data). Preliminary data indicates participants find this approach to be highly acceptable. Progressive data collection and analysis is continuing. Further data on measures of acceptability and psychosocial outcomes of breast cancer risk assessment, and the delivery of personalised breast screening recommendations will be presented.
Conclusions: Tailoring screening to individual risk profiles can support more informed decision-making while identifying women at higher risk who may be missed by current one-size-fits-all approaches. This enables earlier surveillance or targeted interventions and provides personalised risk information, particularly for those who are unaware of their genetic risk or have an unknown family history of breast cancer.
Abstract number 24
THE FINANCIAL IMPACT OF METASTATIC BREAST CANCER: INSIGHTS FROM A QUALITATIVE STUDY
Ashleigh R. Sharman, Cadan Jones, Sophie Lewis, Andrea L. Smith
Introduction/Background: Individuals with metastatic breast cancer (MBC) are living longer due to treatment advances (1), however experience unique challenges associated with ongoing therapy, disease progression, and prognostic uncertainty. In contrast to early-stage breast cancer treated with curative intent, where financial pressures typically diminish as treatment concludes – and focus shifts to recovery and living beyond cancer – the financial burden in MBC is ongoing.
Objectives/Aims: This study aimed to address this research gap by exploring the financial impact experienced by Australian women with MBC.
Description/Methods: A national sample of women with MBC, recruited through community organisations and clinicians, took part in multiple semi-structed interviews conducted via phone or face-to-face over a 12-month period. Interviews were transcribed and analysed using a constructivist approach to thematic analysis.
Results/Outcomes: Thirty-eight women (aged 36-74, living with MBC for 1-23 years) were interviewed. Three themes were identified: (1) complexities and costs associated with healthcare and treatment; (2) workforce participation as protective against financial strain; and (3) systemic barriers to timely and affordable access to cancer drugs and financial support services. All participants reported ongoing financial impacts associated with living with MBC. For many, this began with referral into public or private systems without consultation of existing financial circumstances. Women who were poorly connected to holistic supportive care including peer support, those who were not supported by their employers to continue working with flexible arrangements, and those who struggled to navigate government schemes in a timely manner were at greater risk of experiencing financial toxicity.
Conclusions: Metastatic breast cancer can invoke considerable downward force on the financial security of those diagnosed. Policy makers, employers, health service providers and clinicians must explore mechanisms to provide specialised support that is attuned to the realities of lifelong cancer treatment that accounts for the multidimensional complexities of MBC and financial toxicity.
Abstract number 25
BARRIERS AND ENABLERS FOR PROSTATE CANCER SCREENING IN MIGRANT MEN FROM CULTURALLY AND LINGUISTICALLY DIVERSE BACKGROUNDS: PERSPECTIVES FROM SOUTH AUSTRALIA
Daile Lynn Rung, Timothy Piatkowski, George Gouzounis, Stephen Bolaji, Joshua Trigg, Michelle King-Okoye, Lemlem G. Gebremichael, Michael O’Callaghan, Billingsley Kaambwa, Norma B. Bulamu
Issues addressed: To understand barriers, enablers and preferences for prostate cancer screening among migrant men from culturally and linguistically diverse (CALD) backgrounds.
Methods: Qualitative data was analysed from six focus group discussions (FGD) conducted among CALD men aged over 35 years. Participants were recruited through the Multicultural Communities Council of South Australia. FGD were conducted following a semi-structured guide co-designed with community facilitators. Data was analysed using reflexive thematic analysis.
Results: Each FGD was comprised of five men (total, n=30), from African, Middle Eastern and Southeast Asian communities. Participants were mostly from Africa (70%), aged between 45-59 (63%) and were comfortable communicating in English (73%). Most participants (43%) migrated to Australia on a humanitarian visa. Barriers to screening included lack of knowledge about prostate screening, fear of the unknown, language barriers, cultural norms and stigmas, and financial implications associated with testing. Potential enablers included raising community awareness of prostate cancer and screening services with involvement of community groups; being informed of PSA testing by their general practitioner; making information available in plain English, including visual aids, and resources available in community languages; eliminating the economic burdens of testing; and de-stigmatisation of sexual health in their communities.
Conclusion: Barriers to prostate cancer screening among CALD men are interconnected; the lack of knowledge about prostate cancer contributes to fear of testing and community stigma around a prostate cancer diagnosis. There is a great need for culturally informed prostate cancer health campaigns to improve CALD men’s knowledge and uptake of screening.
So What? We provide insights into why CALD men are reluctant to participate in screening for prostate cancer and the shift needed towards culturally-safe frameworks of care. Screening uptake can be improved by community involvement in the co-design of initiatives to address cultural and religious norms in relation to sexual health.
Abstract number 26
BEYOND THE PATIENT: EXPLORING THE EXPERIENCES OF SUPPORT PEOPLE CARING FOR INDIVIDUALS WITH GASTRIC AND OESOPHAGEAL CANCER.
Jayde Tyczenko, Emma Kemp, Donna Hughes-Barton, Renee J Smith, Maddison Dix, Lorraine Sheehan-Hennessy, Charles Cock, Tim Bright, David Watson, Erin L Symonds
Introduction/Background: Diagnosis, treatment and aftercare of upper gastrointestinal cancers involves comprehensive, multifaceted care needs. These needs are often supported by caregivers, who provide intensive and varied assistance throughout the patient journey. Despite their critical role in supporting survivorship after an upper gastrointestinal cancer diagnosis, limited research has explored these caregivers’ experiences.
Objectives/Aims: This study aimed to understand caregivers’ perspectives on their roles to identify opportunities for improved support.
Description/Methods: Caregivers of individuals diagnosed with gastric or oesophageal cancer within the previous three years were invited to participate in focus groups exploring their experiences with post-diagnosis surveillance. Patient recruitment occurred via hospital clinic lists, with caregivers invited via separate letters provided to patients. Thirteen female caregivers (including 12 spouses) of patients aged 55-80 years (median 75 years) participated in six focus groups (five in-person and one online). Discussions were guided by a semi-structured script. Focus groups were held between March and May 2023 until data saturation was reached. Audio recordings were transcribed verbatim and analysed using reflexive thematic analysis to identify key themes.
Results/Outcomes: Significant caregiver burden was reported across emotional, physical and financial domains. Caregivers assumed advocacy roles in navigating and facilitating access to primary and specialised care services, resulting in lifestyle disruptions and social isolation. Positive impacts of strong support networks and patient-centred healthcare experiences were noted. Recommendations from the identified themes emphasise the need for timely and personalised communication from healthcare providers to support patients and caregivers in effectively navigating complexities of the cancer journey.
Conclusions: Caregivers of individuals treated for oesophageal and gastric cancers carry substantial burdens that impact their wellbeing and lifestyle. Their vital role highlights the need for effective communication from healthcare providers and proactive support services which could contribute to sustainable cancer care for both patients and caregivers.
Abstract number 27
EXPERIENCES, NEEDS, AND PREFERENCES OF CANCER CARE FOR PEOPLE WITH INTELLECTUAL DISABILITY: PERSPECTIVES OF FORMAL AND INFORMAL SUPPORTERS.
Irene Belperio, Jennifer Baldock, Hannah Beinke, Tim Cahalan, Jala Burton, Michelle Bellon
Introduction/Background: People with intellectual disability face persistent disparities in accessing and receiving appropriate cancer care, resulting in poorer cancer-related outcomes compared to the general population. Formal supporters (i.e., paid disability staff), and informal supporters (i.e., family and friends) are known to be central to achieving quality healthcare experiences and outcomes for people with disability. However, there is a significant gap in understanding the experience of cancer care from the perspective of these supporters.
Objectives/Aims: Using inclusive research methods to explore the experiences, needs, and preferences of cancer care for people with intellectual disability from the perspectives of formal and informal supporters in Australia.
Description/Methods: A phenomenological study using semi structured interviews and focus groups was conducted with people with intellectual disability, health professionals, and formal and informal supporters. The focus here is data from people working in disability services, including disability support workers, managers, and compliance officers (n=15); and informal supporters of people with intellectual disability and cancer (n=6), including parents, siblings, co-workers, advocates, and members of Circles of Support. Reflexive thematic analysis was used to construct themes.
Results/Outcomes: Participants highlighted the key role of general practitioners who know the person with intellectual disability, particularly in communicating complex health information. This helped both formal and informal supporters in their roles. Further, nurses and allied health professionals in community, secondary, and tertiary care settings were often identified as most likely to make adjustments in care and communication. They also often assisted with coordination and liaison of information and services. This was especially beneficial for informal supporters who experienced stress.
Conclusion: Comprehensive care is vital to quality cancer care outcomes for people with intellectual disability. More is needed to support people in key formal and informal supporter roles, particularly in sharing necessary and accessible information. Systematic communication and coordination between services and sectors is also a priority.
Abstract number 28
PATIENT EXPERIENCES OF A CHRONIC LIVER DISEASE SCREENING PATHWAY IN AUSTRALIAN PRIMARY CARE: A QUALITATIVE STUDY
Caitlin Clymer, Deborah de Guingand, Sophie Frear, Leon A. Adams, Jon Emery, Nicole M. Rankin, Tara Clinton-McHarg
Background: Chronic liver disease (CLD) is a major public health issue and key risk factor for hepatocellular carcinoma (HCC), often diagnosed at advanced stages when treatment options are limited. Primary care is well-positioned to support earlier detection, but tests commonly used in this setting lack sensitivity for detecting early-stage disease. Accurate non-invasive tests are recommended for use in primary care; however, evidence on patient acceptability and engagement with structured CLD screening pathways is limited. The Identifying liver Cirrhosis and liver Cancer in primary Care (IC3) pathway is a two-step screening approach using blood-based biomarkers (Fibrosis-4 Index and Hepascore), followed by Fibroscan to support earlier detection and guide specialist referral for at-risk patients in Australian primary care. Understanding patient acceptability and engagement with the IC3 pathway is critical to supporting pathway adoption and sustainability.
Aim: To identify factors shaping patient engagement with the IC3 pathway and explore how participation influenced CLD knowledge and health-related behaviours.
Method: Twenty semi-structured interviews were conducted with a purposive sample of patients allocated to the IC3 intervention pathway (mean age 59.1 years; 60% male; 10% regional). Interviews were analysed inductively, then deductively using the Theoretical Domains Framework (TDF).
Results: Findings were mapped across eight TDF domains. Screening was broadly acceptable; accessibility, minimal cost, and non-invasive testing were key enablers. Limited prior knowledge of CLD and low perceived personal risk were common, but risk communication improved understanding and prompted lifestyle change. Anticipatory anxiety was reported yet did not deter participation, mitigated by clear provider communication. Barriers emerged following specialist referral, including wait times and travel burden, which disproportionately affected regional participants.
Conclusion: CLD screening in primary care is acceptable to patients at risk and may catalyse risk awareness and behaviour change. Clear communication, GP endorsement, and stronger primary-tertiary care coordination are essential for equitable and scalable implementation.
Abstract number 29
PATIENT NAVIGATION FOR PEOPLE AFFECTED BY CANCER FROM CULTURALLY AND LINGUISTICALLY DIVERSE BACKGROUNDS – THE PEARL STUDY
Carolyn Ee, Jon Emery, Raymond J. Chan, Kylie Vuong, Cannas Kwok, Suzanne Grant, Carla Thamm, Ashanya Malalasekera, Wei Chua, Elisabeth Elder, Kirsty Stuart, Catherine Paterson, Freya MacMillan, Joel Rhee, Stacey George, Larissa Nekhlyudov, Sameera Suleman, Eric Yeung, David Chua, Richard De Abreu Lourenco, Patty Chondros, Lynette Law
Background: Cancer survivorship in Australia is shaped by complex clinical, social, and cultural factors. People from Chinese- and Vietnamese-speaking backgrounds often experience substantial barriers to accessing survivorship care, resulting in unmet needs and poorer quality of life, despite national priorities for more equitable care. Language barriers, culturally based stigma and limited culturally appropriate support contribute to these disparities. Patient navigation has shown promise in addressing these challenges; however, there are currently no scalable, culturally tailored patient navigation programs implemented nationally for culturally and linguistically diverse (CALD) people with cancer. The PEARL program was co-designed with community organisations, consumers, and primary care partners to address this gap.
Aim: To evaluate whether PEARL improves health-related quality of life (HRQoL) for Chinese and Vietnamese-speaking adults with cancer and identify contextual factors influencing implementation.
Methods: PEARL is a pragmatic randomised controlled Type II hybrid effectiveness-implementation trial delivered through community organisations across Queensland, South Australia, and New South Wales. Eligible participants are adults who speak Mandarin, Cantonese, or Vietnamese at home and have completed active cancer treatment within the preceding two years. Participants are randomised (1:1) to PEARL or usual care. Bilingual patient navigators first identify barriers, coordinate services, and facilitate re-engagement with primary care. Participants are matched with a peer navigator who provides in‑language support and information, and emotional support from a lived experience perspective. Primary outcomes include HRQoL (FACT‑G) at six and twelve months and receipt of survivorship care in primary care. Implementation is evaluated using RE‑AIM/PRISM and qualitative interviews.
Implications: PEARL is expected to improve HRQoL and strengthen engagement of Chinese and Vietnamese cancer survivors with primary care. It is anticipated that PEARL is scaled up nationally as a model of culturally responsive navigation for diverse communities in Australia.
Session 4: Primary Care Clinicians - Roles Across the Cancer Continuum
Abstract number 30
THE ROLE OF THE GENERAL PRACTITIONER IN CANCER CARE AFTER DIAGNOSIS: AN INTERNATIONAL COMPARISON
Stegmann Mariken E, Urquhart Robin, Balasubramaniam Kirubakaran, Huizinga Famke, Ee Carolyn, Fok Rose, Fidjeland Heidi L, Rasmussen Linda A, Adam Rosalind, Accord Saskia, Brandenbarg Daan
Introduction/Background: General practitioners (GPs) are well-positioned to contribute across the cancer care trajectory after diagnosis. Yet a systematic international comparison of the GP’s role in this context has been lacking.
Objectives/Aims: To compare the GP’s role in cancer care after diagnosis across countries with strong primary care systems, examining when and how GPs interact with patients and the extent to which these roles are formalised; and to identify innovations aimed at strengthening this role.
Description/Methods: An international process mapping and scoping study was conducted across ten countries (Australia, Canada, Denmark, Netherlands, Norway, Republic of Ireland, Singapore, Sweden, United Kingdom, USA) via the Cancer in Primary Care International Network (Ca-PRI). Five iterative stages were used: establishing an expert working group; rapid scoping review; development and population of a bespoke data collection template informed by the WHO Health Systems Performance Framework; focus groups at the Ca-PRI 2025 workshop (Manchester, UK); and narrative synthesis and triangulation.
Results/Outcomes: No country has implemented a nationally formalised GP role in cancer care after diagnosis. However, jurisdiction-specific formal roles exist in several countries, including GP-led survivorship clinics, delegated surveillance tasks, and formal GP involvement in palliative and end-of-life care. Despite this, GP involvement in the care of patients after diagnosis of cancer is reported to be high across all countries. High fragmentation of care was consistently reported, with electronic medical record (EMR) integration between primary and secondary care mostly dependent on jurisdiction or non-existent.
Conclusions: GPs are de facto providers of cancer care after diagnosis internationally, yet formal roles remain jurisdiction-dependent and inconsistent. Role clarity through guidelines, structured education, and EMR integration to enable real-time information sharing between primary and secondary care are needed to optimise GP contributions to sustainable cancer care. The UK’s stratified follow-up care pathways may be considered a leading innovation with promising results.
Abstract number 31
EVALUATING A MULTISTATE GP-LED INTERVENTION TO IMPROVE COLORECTAL CANCER SCREENING: PRELIMINARY FINDINGS FROM THE MAIL, GP & SCALE TRIAL
Eleonora Feletto, Anna Kelly, Joanna Jaques, Karen Canfell, Jie-Bin Lew, Natalie Taylor, 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, Qingwei Luo
Introduction: Regular screening reduces the burden of colorectal cancer (CRC). Australia’s National Bowel Cancer Screening Program (NBCSP) has been effective despite relatively low participation (~40%). General practice has a critical role in improving participation. The MAIL, GP & SCALE (MGS) trial evaluated the effectiveness of a general practice (GP)-led intervention to improve CRC screening.
Aim: To assess a hybrid type 2 effectiveness–implementation trial to measure changes in CRC screening uptake among NBCSP eligible patients following implementation of a GP-led intervention.
Methods: GPs across four sites in Queensland, South Australia and New South Wales were randomised to either the intervention or usual care. The co-designed intervention included: (1) a CRC screening decision support aid, (2) electronic point-of-care prompts, (3) clinical information system modifications to streamline workflows, and (4) education. Implementation began in February 2025 and was supported by site-based Clinical Trial Coordinators. Deidentified, aggregated practice level CRC screening data were extracted from practice software monthly from September 2024 to May 2025. We compared the proportion of NBCSP eligible patients who completed a screening test during the four-month intervention period with the five-month pre-intervention period, relative to usual care practices.
Results: Eighty-three practices (41 intervention; 42 usual care) completed the trial. Early analysis suggests that the intervention resulted in a positive shift in CRC screening. Implementation fidelity varied across components: fidelity was high for clinical information system modifications, specifically focused on the integration of the National Cancer Screening Register; medium for the electronic point of care prompts; and lower for the decision support aid and education. Full effectiveness results will be available at the time of presentation.
Conclusions: This trial will provide critical multistate evidence of a scalable GP-led approach to increasing CRC screening, with findings to inform national primary care approaches to improve early detection and reduce CRC burden.
Abstract number 32
ELIMINATING CERVICAL CANCER IN AUSTRALIA: QUALITATIVE INSIGHTS INTO THE ROLE OF GENERAL PRACTICE IN ADDRESSING INEQUITIES IN UNDERSERVED POPULATIONS
Allyce Counsell, Deborah Bateson, Claire Vajdic, Melissa Kang
Background: The elimination of cervical cancer through vaccination, screening, and treatment is a global health priority. Despite organised cervical screening and a human papillomavirus (HPV) vaccination program in Australia, inequities persist for multicultural communities with lower rates of vaccination, screening and treatment. General practitioners (GPs) are crucial for delivering cervical cancer prevention services and have the potential to reduce inequities.
Aim: To examine and understand the role of general practice in facilitating cervical cancer prevention among multicultural populations within metropolitan Sydney and rural New South Wales (NSW).
Methods: GPs were recruited using purposive sampling. Oneonone semistructured interviews were conducted with 31 NSW-based GPs practising in areas with high multicultural populations. Interviews focused on GPs role in delivering HPV vaccination, cervical screening (including self-collection), follow-up of screening results and referral to colposcopy and their views enhancing engagement within multicultural populations. Interviews were transcribed and thematic analysis was conducted using an inductive approach.
Results: Preliminary analysis has identified the following early themes: 1) GPs play an important role in proactively discussing cervical cancer prevention activities to increase awareness and engagement in multicultural populations; 2) Longitudinal relationships with GPs enhances engagement and opportunities to discuss cervical cancer prevention activities; 3) GPs themselves have less engagement with HPV vaccination compared to cervical screening; 4) Technology and systems are important for facilitating and optimising care. Formal analysis and theme development to be completed by August 2026.
Conclusion: Our findings highlight the important role of general practice in engaging and delivering cervical cancer prevention activities among multicultural populations who need increased education compared to non-multicultural populations. These findings will help inform policy and practice within general practice and public health particularly regarding catch-up HPV vaccination.
Abstract number 33
AUSTRALIAN GP PERSPECTIVES ON PREVENTING AND MANAGING WEIGHT GAIN IN BREAST CANCER SURVIVORSHIP: A CFIR-INFORMED QUALITATIVE STUDY
Lisa Hanlon, Carolyn Ee
Introduction / Background: Weight gain following breast cancer treatment is common and associated with poorer long-term outcomes, including increased risk of recurrence, cardiovascular disease, type 2 diabetes and reduced quality of life. In Australia, general practitioners (GPs) play a key role in ongoing survivorship care, however, the optimal model of care required to for effective prevention and management of weight gain in breast cancer survivors remains unclear.
Objectives/Aims: This study explored GP perspectives on preventing and managing weight gain in breast cancer survivors.
Description/Methods: A qualitative study was conducted using semi-structured interviews with 14 GPs across metropolitan, regional and rural Australia. Interviews explored experiences with supporting breast cancer survivors to manage their weight, perceived barriers and facilitators, and views on optimal models of care. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Emerging themes were mapped to constructs from the Consolidated Framework for Implementation Research (CFIR) to identify multi-level determinants influencing care delivery.
Results/Outcomes: Preliminary findings suggest that although GPs recognise weight management as an important component of survivorship care, responsibility for addressing it is often unclear across the oncology-primary care interface. Barriers in primary care include limited consultation time, lack of structured survivorship pathways, constrained access to allied heath within chronic condition management plans and uncertainty regarding referral pathways for dietary and behavioural support. Broader challenges include socioeconomic barriers, patient health literacy and reduced service availability in rural and remote areas. Facilitators include multidisciplinary collaboration, improved survivorship care planning and clear clinical guidance to support weight management discussions in primary care.
Conclusions: These findings highlight gaps in chronic condition management for breast cancer survivors. Strengthening primary care-led models of care may optimise the prevention and management of weight gain after breast cancer.
Abstract number 34
EVALUATING A NATIONAL ONLINE TRAINING PROGRAM FOR PRIMARY CARE PRACTITIONERS TO SUPPORT TRAUMA‑INFORMED CERVICAL SCREENING FOR PEOPLE WITH INTELLECTUAL DISABILITY
Lauren Winkler, Kimberley Allison, Michael David, Rosalie Power, Sally Sweeney, Iva Strnadová, Jane Usser, Caroline Basckin, Heather Jolly, Ee-Lin Chang, Allison Cater, Julie Loblinzk, Deborah Bateson
Background: Primary care practitioners are crucial for supporting participation of people with intellectual disability in Australia’s National Cervical Screening Program and ensuring equitable elimination of cervical cancer for all Australians. Training in disability‑inclusive, trauma‑informed cervical screening is limited in primary care education and professional development. The ScreenEQUAL project co‑produced and evaluated evidence‑informed education to address this workforce need.
Aims: To assess changes in practitioner confidence and preparedness to offer and provide cervical screening for people with intellectual disability after completing an accredited online training module.
Methods: As part of the ScreenEQUAL clinical trial, Australian primary care practitioners completed a self‑paced 45‑minute online training module and pre‑ and post‑training surveys, including a 15‑item confidence scale (score range 15–60). Changes in confidence were examined using repeated‑measures ANCOVA adjusting for age, years in practice, and gender. Participant characteristics were summarised descriptively.
Results: Complete data were available for 245 of 364 participants, including General Practitioners (67.6%), Nurses and Midwives (29.4%), and Nurse Practitioners (1.6%). Most participants were female (87.6%), with a mean age of 46.9 years (SD = 10.4) and a mean of 18.8 years in clinical practice (SD = 21.1). Mean confidence scores were higher at post‑training (M = 51.09, 95% CI 47.14–55.04) than pre‑training (M = 43.74, 95% CI 39.29–48.19). Changes in confidence over time were moderated by age, with larger gains among older participants (time × age: F(1,235) = 4.70, p = .031, partial η² = .020). No significant moderation by gender or years in practice was observed.
Conclusions: Completion of a self‑paced online training module coincided with higher confidence and preparedness to provide trauma‑informed disability‑inclusive cervical screening for people with intellectual disability among primary care practitioners. Targeted workforce education represents a critical strategy for supporting Australia’s progress towards equitable cervical cancer elimination by 2035. Training materials will be made freely available to support national and potential international scale‑up in the future.
Abstract number 35
SMARTERSCREEN: SMS PROMPTS FROM GENERAL PRACTICE TO BOOST NATIONAL BOWEL CANCER SCREENING – A CLUSTER RANDOMISED TRIAL
Jennifer McIntosh, Lyn Buchanan, Patty Chondros, Belinda Goodwin, Tina Campbell, Nancy Baxter, Jon Emery, Angelos Petris, Carlene Wilson, Finlay Macrae, Jie-Bin Lew, Makala Castelli, Sabine Fletcher, Claire Nightingale, Kate Broun, Glenn Austin, Joyce Jiang, Mark Jenkins
Background: Despite Australia’s National Bowel Cancer Screening Program (NBCSP), bowel cancer incidence remains high. A 2020–21 trial of an SMS from general practice containing a weblink (‘SMARTscreen’), increased NBCSP uptake by 16.5%. The SMARTERscreen trial aimed to replicate this effect in a larger population and measure any impact of including a weblink.
Trial design: SMARTERscreen was a three‑arm cluster randomised controlled trial in general practices in two Australian states. Practices were randomised to send either a single SMS (SMS‑only), a similar SMS with a weblink to motivational and instructional videos (SMS‑plus), or usual care.
Methods: Eligible people included regular patients aged 49–60 years, due for their NBCSP kit, who had not opted out of receiving SMS. SMS were sent two weeks prior to participants’ NBCSP due date. The primary outcome was return of the NBCSP kit within four months of dispatch, obtained from the National Cancer Screening Register. A process evaluation guided by the MRC framework included interviews with staff from a sample of intervention practices.
Findings: Fifty-nine practices and 8,006 participants were included: 2,976 (SMS-only), 2,374 (SMS-plus) and 2,646 (control). There were no differences observed in proportion of kits returned: 29.6% (SMS-only), 30.5% (SMS-plus) and 30.3% (control). Only 2.0% of participants opted out of either SMS; 2.2% of SMS-plus participants opened the weblink. Nineteen intervention practices were interviewed. Staff reported high intervention fidelity. There were suggestions null findings might reflect SMS fatigue, fear of scams and reduced trust. Despite this, every general practice used SMS and suggested it was effective if people were expecting it and it was part of regular practice communications.
Conclusion: Sending SMS did not increase NBCSP kit returns in this trial. Day and time sent was different from SMARTscreen which might have impacted effectiveness. Nonetheless, SMS remain a valuable tool in general practice.
Abstract number 36
UNDERSTANDING GENERAL PRACTITIONERS’ BARRIERS AND FACILITATORS TO IMPLEMENTING EFFECTIVE BEHAVIOUR CHANGE STRATEGIES FOR CULTURALLY AND LINGUISTICALLY DIVERSE CANCER SURVIVORS
Darren Haywood, Evan Dauer, James Murray, Jennifer Haywood, Nicolas H. Hart
Background: In Australia, approximately 28% of the population were born overseas, and 23% speak a language other than English at home. Cancer survivors from culturally and linguistically diverse (CALD) backgrounds in Australia experience poorer outcomes compared to those not from CALD backgrounds. Factors such as lower health service engagement and the lack of culturally appropriate care contribute to these poor outcomes. A key aspect for improving outcomes for cancer survivors generally is the reduction of negative health behaviours and the increase of positive health behaviours. General practitioners (GPs) are ideally placed to work with cancer survivors to improve their health behaviours, and can GPs implement behaviour change techniques (i.e., habit formation, goal setting and planning, antecedents and substitution, etc.), which are effective in general oncology populations. However, research also shows that the use of BCTs is not commonly successful in changing behaviour or improving outcomes for people from CALD backgrounds
Aim: To understand GPs’ perceived barriers and facilitators to implementing effective behaviour change strategies for CALD cancer survivors relating to their (a) Capability, (b) Opportunity, and (c) Motivation (COM-B Model).
Methods: A qualitative interview approach was used. GPs, with experience of providing services to CALD cancer survivor participants, participated in semi-structured interviews guided by the COM-B model. The interviews were recorded and transcribed. Reflexive Thematic Analysis was used to analyse the data.
Results: 14 GPs participated in the study. Four overarching themes were developed; (1) What Do I Know?, (2) Person and Empowerment, (3) Lost in Translation, and (4) How Can We Get This to Work?
Conclusions: GPs identified priorities including building GP capability in culturally responsive care and practical BCT guidance; developing culturally appropriate behaviour change resources, and workable care pathways; and supporting motivation through person-centred, empowering culturally appropriate consultations.
Abstract number 37
PRIMARY CARE INSIGHTS ON COLORECTAL CANCER SCREENING IN CULTURALLY DIVERSE COMMUNITIES: FINDINGS FROM A QUALITATIVE STUDY (PRISM-GP)
Farwa Rizvi, Carolyn Ee, Janelle Jones, Patricia Livingston, Victoria White
Background: Participation in colorectal cancer (CRC) screening in Australia remains below national targets among culturally and linguistically diverse (CALD) populations. General practitioners (GPs) play an important role in facilitating participation in the National Bowel Cancer Screening Program (NBCSP).
Aim: To explore GP perspectives on CRC screening participation, barriers and communication strategies to enhance engagement among CALD populations in Victoria, Australia.
Methods: Semi-structured interviews were conducted with 24 GPs in Victoria, Australia (Oct 2025–Feb 2026), recruited via snowball sampling through clinical networks, social media, and peer-to-peer referrals. Data were analysed using reflexive inductive and deductive thematic data analysis.
Results: Many GPs were from CALD backgrounds (Pakistani n=9, Indian n=8, Chinese n=2, and one each from Mauritian, Malaysian, Italian, Ukrainian, and Sri Lankan backgrounds). 21 (87.5%) GPs were female; while three (12.5%) were male. Preliminary findings highlight persistent cultural and behavioural barriers to CRC screening. GPs reported routinely initiating screening discussions with eligible patients (≥50years). Non-completion of iFOBT kits despite postal receipt was commonly described, with GPs attributing this to culturally influenced discomfort around handling bodily waste, particularly among South Asian and Middle Eastern groups. Higher uptake among some Chinese-background patients was perceived to reflect greater health-seeking behaviour and familiarity with screening. GPs also reported that screening uptake appeared higher when kits were provided directly in-clinic via the Alternative Access Pathway, as many patients were described as putting kits on the shelf after receiving kits by post and not completing screening. GPs identified culturally safe communication and co-designed multilingual resources as key enablers for screening engagement.
Implications for practice/policy: Addressing CRC screening disparities requires scalable, culturally tailored interventions. GPs can play an important role in supporting CALD community members to engage in screening programs. Interventions embedded into routine care and supported by multilingual resources may improve participation among CALD communities.
Funding: PC4 Training Award for Early Career Researchers
Abstract number 38
VOICES OF OLDER INDIVIDUALS AND THEIR PRIMARY CARE CLINICIANS IN CANCER CARE (CAN-VOICE–PART I): A QUALITATIVE STUDY ON EXPERIENCES AND CHALLENGES FROM THE PRIMARY CARE PHYSICIANS AND PRACTICE NURSES’ PERSPECTIVE
Chad Yixian Han, Elizabeth Halcomb, Kathryn Leaney, Joel Rhee, Anna Mislang, William Dale, Raymond Chan, Elizabeth Chuk, Lawrence Kasherman, Shriya Mahatme, Timonthy To, Alex Fauer, Carolyn Ee
Introduction/Background: The Australian healthcare system faces a growing demographic of older adults with cancer and comorbidities. General practitioners (GPs) and practice nurses (PNs) provide essential holistic care, yet their experiences and challenges remain under-explored.
Aim: This study aims to explore the experiences and challenges faced by GPs and PNs and potential solutions, when caring for older Australians affected by cancer across the cancer care continuum.
Methods: Qualitative descriptive study providing rich descriptions of the experiences of GPs and PNs in providing primary cancer care to older adults, through purposive and snowball sampling methods for recruitment. Individual semi-structured interviews were audio-recorded, transcribed verbatim and analysed using qualitative content analysis. Inductive codes were generated, and codes representing challenges and solutions for providing primary cancer care to older adults affected by cancer were then mapped to domains in the Theoretical Domains Framework using a deductive approach.
Results: Participants (N=21) included 16 primary care physicians and 5 PNs (14 female, 7 male) with median age of 43 years (IQR 36.5-53.5). The cohort averaged 17.5 years of experience in geriatric oncology, representation from five states, predominantly within regional (n=10) and mixed-billing (n=17) settings. Analysis revealed significant barriers rooted in Environmental Context and Resources, including system fragmentation, hidden administrative burdens, and inadequate remuneration. Inductive findings highlighted Role Tension and Workforce Shortages as critical hurdles. Participants identified Knowledge gaps regarding chronic toxicities and survivorship pathways. Conversely, providers maintained a strong Social/Professional Identity as holistic coordinators and advocates for patient-centred decision-making. Behavioural Regulation, the use of templates and structured health assessments, emerged as a vital enabler for managing complex multimorbidity.
Conclusions: While GPs and PNs are foundational cancer care, systemic inefficiencies and funding gaps limit their effectiveness. Improving communication pathways between primary and specialist care and providing targeted education on survivorship and toxicities are essential to enhance care quality and burnout.