National Bowel Cancer Screening Program - information for health professionals

Bowel cancer is one of the most common forms of cancer in Australia, and around 80 Australians die each week from the disease. Bowel cancer can be treated successfully if detected in its early stages, but currently less than 40 per cent of bowel cancers are detected early.

The second phase of the National Bowel Cancer Screening Program (the Program) commenced on 1 July 2008 and will offer testing to people turning 50, 55 or 65 years of age between January 2008 and December 2010. The program is being phased in gradually to help ensure that health services, such as colonoscopy and treatment services, are able to meet any increased demand. This is consistent with the introduction of other screening programs, such as the National Cervical Screening Program, which was also phased in over a number of years.

People eligible to participate in the program will receive an invitation through the mail to complete a simple test called a faecal occult blood test (FOBT) in the privacy of their own home and mail it to a pathology laboratory for analysis. There is no cost involved in completing the FOBT. These screening tests have been shown in overseas clinical trials and in the Bowel Cancer Screening Pilot Program to be simple to use and highly effective. Participants with a positive FOBT result will be advised to discuss the result with their doctor, who will generally refer them for further investigations, usually a colonoscopy.

Changes to your NBCSP online services

From April 2009, Medicare Australia will introduce the new Health Professional Online Services (HPOS) website. This will offer a single entry point for all your online service needs.

To access HPOS, you will need a Public Key Infrastructure (PKI) individual certificate or your existing logon. Click on the For health professionals tab and you will find the HPOS logon located on the top right.

Who will be invited to take part?

People who are within the eligible population will be invited to take part in the program. The eligible population is Australians turning 50, 55 or 65 years of age between 1 January 2008 and 31 December 2010, who hold a Medicare card or DVA gold card.

Temporary visa holders and temporary residents will not be invited to participate in the program regardless of whether they are in the specified age range.

Why are only people turning 50, 55 or 65 years of age invited to take part?

Research shows that the risk of developing bowel cancer rises significantly from the age of 50. The National Health and Medical Research Council recommends that organised FOBT screening of average risk people should commence at 50 years of age.

It is important that the screening program be introduced slowly to provide time to ensure that health services, such as colonoscopy services, are able to meet any increased demand. That is why, during this second phase of the program, only those turning 50, 55 or 65 years of age between January 2008 and December 2010 are being invited to screen.

What is the screening process?

People eligible to participate in the Program will receive a pre-invitation letter followed by an invitation pack, including an information booklet and an FOBT kit, in the mail. Those who choose to participate will complete the FOBT and a Participant Details Form and send both to a pathology laboratory, where the test will be analysed.

Program participants will be encouraged to nominate their usual GP or medical practice on their Participant Details Form, but this will not be compulsory. The result of the test will be sent to the participant, their GP (if nominated) and the National Register. The FOBT result sent to nominated GPs or practices will include full contact details for the participant.

Participants with a positive FOBT will be advised to see their GP to discuss the result and usual referral procedures for follow up tests, such as a colonoscopy, will apply. Nominated GPs or practices may also receive reminder letters advising them that, according to the information held by the Register, the participant has not followed up their positive FOBT result with their GP or attended for a colonoscopy or other bowel examination.

A person with a positive FOBT is 12 to 40 times more likely to have colorectal cancer than a person with a negative test. It is therefore essential that any positive FOBT is appropriately investigated. To ensure that all Program participants with a positive FOBT result receive adequate follow up, Program Coordinators will be recruited in each state and territory. Program Coordinators may contact health professionals and their patients with a positive FOBT result to assist and encourage progression through the screening pathway.

Role of Medicare Australia:

Medicare Australia administers the National Bowel Cancer Screening Register which commenced sending invitations in July 2006. The Register issues invitations to participate in the Program, records participants' details including screening history, FOBT and colonoscopy results as well as issuing reminder letters to participants and their nominated doctor/medical practice. Medicare Australia also operates the Information Line which provides information regarding the Program to the general public and medical practitioners during business hours, and the Information Manager service to encourage participants with a positive FOBT result to complete the screening pathway.

To send invitations to participate in the Program, Medicare Australia selects invitees from either the Medicare enrolment records or the Department of Veterans' Affairs enrolment file as authorised by a service arrangement under subsection 7(2) of the Medicare Australia Act 1973.

Personal information and test results are kept private and confidential. Information kept on the Register is protected by law (the Privacy Act 1988) and personal details are released in accordance with the Information Privacy Principles of that Act.

Medicare Australia's role in the Program includes:

• establishment and maintenance of the National Bowel Cancer Screening Program Register (the Register)
• collection of information about participation in the Program and test results and
• mailing house functions.

Role of General Practitioners:

General practitioners are asked to:

• Encourage their patients who are sent a FOBT through the Program, and for whom FOBTs are clinically relevant, to participate in the Program.
• Assess those with a positive FOBT and refer them for further examination as clinically indicated, for example, a colonoscopy.

• Notify the Register of referral/non referral for colonoscopy or other bowel examination for participants with a positive FOBT, utilising the Assessment Form – Referred for colonoscopy/Not referred for colonoscopy following a positive FOBT result [PDF, 144Kb]. An information payment will apply.
• Manage individuals identified as being at high risk of bowel cancer in accordance with the NHMRC Guidelines.
• Inform individuals that the Program only offers one-off FOBT screening, and that the NHMRC Guidelines recommend screening with FOBT every 2 years from the age of 50.

Role of Specialists:

Specialist services and their submission of data to the Register plays a fundamental role in the screening pathway. Collection of data relating to Program participants’ journey through the screening pathway is critical to monitoring and evaluating the impact and outcomes of the Program.

Specialists are asked to:

• Provide follow-up diagnostic procedures associated with referrals received from GPs.
• Manage individuals identified as being at high risk of bowel cancer in accordance with the NHMRC Guidelines.
• Notify the Register about procedures and results utilising the Colonoscopy Report [PDF, 185Kb] or the Histopathology Report [PDF, 140Kb]. An information payment will apply. These forms can also be completed online at the Cancer Screening website.

Payment Arrangements

Standard Medicare attendance items apply to consultations with Program participants.

Medical practitioners, specialists and pathologists will receive a payment for providing information to the Register about consultations and medical procedures for Program participants who have received positive FOBT results.

An information payment will be paid for each correctly completed Program form that provides information to the Register about colonoscopies and histopathology performed for Program participants who have received a positive FOBT result.

In order to receive this payment medical practitioners need to complete a Payment Account Details for Service Provider form. The details provided will be used to make payments for complete information forms received. All payments will be made to the bank account nominated on this form. Medical practitioners who wish to register and nominate the same bank account details for all locations can do so by ticking the appropriate box on the Payment Account Details for Service Provider form.

Information payments for the Program are subject to GST.

Medical practitioners need to advise Medicare Australia of their ABN by completing the form Notification of ABN and Medicare Australia reference IDs for tax treatment purposes and Recipient Created Tax Invoice (RCTI)Agreement. You can obtain further information at GST and your practice. Forms are available at GST.

To receive this payment, after completing and submitting a Payment Account Details for Service Provider form, one of the following forms needs to be completed and sent to the Register for each Program participant:

• Assessment form – Referred/Not Referred following a positive FOBT result
• Colonoscopy Report
• Procedure Report – Adverse Outcomes
• Histopathology Report

Submission of forms

Online submission of Program forms is now available.

Being able to complete and submit forms online will eliminate the requirement to fill in forms by hand and then having to mail/fax the forms to the Register.

Electronic lodgement of GP Assessment form – Referred/Not Referred following a positive faecal occult blood test (FOBT)

The Assessment form – Referred / Not referred for colonoscopy following a positive faecal occult blood testing result can be submitted online by accessing the form through the Health Professional Online Services (HPOS).

Or

The Cancer Screening website:
go to National Bowel Cancer Screening Program > Forms > Links to electronic forms
The Colonoscopy, Adverse Outcomes and Histopathology Reports can also be submitted online at the Cancer Screening website.
Medical practitioners may also lodge forms with the National Bowel Cancer Screening Program Register:

• by free fax to 1800 115 062 or
• by mail to the NBCSP Register
  Reply Paid 83061
  Hobart TAS 7001

Frequency of payment and statements

The Register will make monthly payments to the bank account nominated on the Payment Account Details for Service Provider on the ninth day (or next working day) for correctly completed forms lodged the previous month. Monthly statements will be provided for reconciliation and taxation purposes. The statements will include details regarding payments, such as patient name, date of consultation and GST.

Where incomplete information is provided and the Register is not able to make a payment, the medical practitioner will be contacted for additional information.

More information:

For more information about the National Bowel Cancer Screening Program visit the Commonwealth Department of Health and Ageing website at:

• Cancer Screening website

For more information about the National Bowel Cancer Screening Program Register and additional Program materials, you can call the: 

National Bowel Cancer Screening Register Information Line on 1800 118 868**

For enquiries regarding the correct procedures for completion of FOBT kits:

Dorevitch Pathology FOBT helpline on 1300 738 365.

State and Territory Cancer Councils provide a confidential service where patients can talk about their concerns or questions about cancer with specially trained staff. The staff can send written information and provide contact details of services in the local area. The Helpline also supports general practice with information on diagnosis, treatment and care.

The Cancer Council Helpline: 13 11 20*

Translating and Interpreting Service: 13 14 50*

* call charges apply from mobiles or pay phones only

** call charges apply

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Last updated: 3 September, 2009