It has been recommended that risk-stratified cancer screening for breast and bowel cancer should be implemented (Hull et al., 2020; Stephenson, 2021). By targeting interventions for patient groups who will benefit most and reduce screening for those that will benefit least, risk-based cancer screening can increase the early detection of cancer with greater precision (Clift et al., 2021; Emery et al., 2023).
This will reduce preventable deaths, unnecessary use of clinical resources and prevent the limited cancer care workforce from being further strained. As of 2023, there are no risk-based cancer screening programs in Australia, apart from a risk-based lung cancer program due to launch in 2025 (Cancer Australia, 2023).
Shifting from Australia’s current one-size fits all approach to breast and bowel cancer screening will require greater primary care involvement in early detection. Primary care providers (PCPs) must be supported to play a bigger role in increasing patient acceptability towards less screening for low-risk individuals; and upskilled to improve risk assessment and communication with patients (Keogh et al., 2019). Australia’s limited cancer care workforce issues need to be addressed before transitioning to a risk-based approach for bowel and breast cancer screening.
