Bowel cancer prevention and early detection in primary care

Enabling timely and affordable access to new cancer treatments for Australian cancer patients.

The Primary Cancer Research Group was established at the University of Melbourne in 2013 and has become the biggest primary care cancer research team in the world. The team has accrued over $30,000,000 of funding and published over 160 publications since 2018. The research group has steadily grown and currently includes 34 core team members working in three distinct areas:

*Data linkage – linking primary care data to hospital and clinical cancer registries to study the impacts of patterns of care and impacts on patient outcomes, as part of a Victorian Comprehensive Cancer Centre (VCCC) Alliance research program.

*Clinical trials – we are currently running nine randomized controlled trials (RCTs) in general practice testing novel interventions covering cancer prevention, risk-based screening, pharmacogenomics, and early cancer diagnosis in primary care.

*Primary care trial infrastructure and capacity building – the Primary Care Collaborative Cancer Clinical Trials Group (PC4) and PARTNER national trial networks.

The evolution and growth of the team reflects the success in obtaining competitive research funding through effective national and international collaboration, and development of effective teams to execute research.

The Primary Cancer Research Group has a range of innovative new studies focused on bowel cancer prevention and early detection in primary care currently in progress or due to commence in the near future. These studies aim to increase participation in population bowel cancer screening (through the National Bowel Cancer Screening Program) and implement new evidence-based guidelines about using aspirin for bowel cancer prevention.

The SCRIPT Trial: a study of DNA testing to tailor bowel cancer screening in primary care
The SCRIPT trial is a randomised controlled trial measuring the effect of using a genomic (DNA) test for to tailor bowel cancer screening according to an individual’s risk of the condition. Differences in people’s DNA can tell us about someone’s risk of bowel cancer, even if there has been no family history of bowel cancer. The intervention includes the DNA test and then tells participants what type of bowel cancer screening is best for them. We will measure whether this personalised risk information and screening recommendation helps participants make better decisions about the most suitable form of bowel cancer screening for them.

Funded by a dedicated grant from the Victorian Cancer Agency Prevention and Screening Research Grant, SMARTscreen will measure the impact of sending an SMS to prompt 50 -60-year-old patients to do their National Bowel Cancer Screening test. The SMS includes an endorsement from the patient’s general practice, a positive narrative video about bowel cancer screening and an animated video describing how to do the screening test. The intervention is evidence-based and simple, and if effective will have an impact on increasing the early detection of colorectal cancer.

SMARTERscreen will involve co-designing two SMS interventions (an ‘SMS only’ and an ‘SMS bundle’) drawing on evidence from the SMARTscreen pilot. The SMS only will include a personalised message with an endorsement from the patient’s general practice, and the SMS bundle will have an additional link in the SMS to videos with motivational and instructional content. General practices will be randomised to one of three groups: the control group (no SMS), SMS only group, or the SMS bundle group. Patients will be eligible if they are aged between 50 and 60 years old and are due for their NBCSP kit. We will compare the uptake of the NBCSP between the three arms of the trial to measure effectiveness of the different interventions on screening uptake. We will explore the acceptability of the SMS to patients and general practice staff and conduct a cost-effectiveness analysis to inform the economic efficiencies and scalability of sending SMS to patients in a nationwide program.

Skin melanomas, breast, bowel, and prostate cancer were the most diagnosed cancers in Australia in 2019. The MAGPIE (Multi-cAncer genomic risk assessment to target screening in General PractIcE) study is the first of its kind in the world, aiming to pilot the use of a multi-cancer polygenic risk score (DNA test) in primary care. Building off the success of the SCRIPT trial, MAGPIE will determine how primary care patients use the information from a multi-cancer DNA, which provides their personalised risk of multiple cancers, along with tailored cancer screening recommendations. It aims to determine how best to deliver this risk and screening information to ensure it helps people make the best decision about doing cancer screening tests.

The SITA Trial: Should I take aspirin?
The SITA Trial is testing a patient-decision aid about whether to take low dose aspirin to reduce their risk of bowel cancer and other long-term conditions. The trial was developed after Cancer Council Australia published new guidelines about the use of low dose aspirin in people aged 50 to 70 years. This randomised controlled trial is testing the effect of the new decision aid on informed decision-making and actual use of aspirin.

  • Recruitment

    General practice patients from participating practices are invited to take part in this research, and the Primary Care Cancer Research team welcomes interest from Victorian practices. If this is something you would like to hear more about, please get in touch with the relevant study contact below.

    The SCRIPT Trial: Sibel Saya, Study Coordinator & Genetic Counsellor

    SMARTscreen: Anna Wood, Project Manager

    SMARTERscreen: Anna Wood, Project Manager

    The MAGPIE Study: Sibel Saya, Study Coordinator & Research Fellow

    The SITA Trial: Shakira Milton, Study Coordinator & PhD Candidate

  • Principle Investigators

    The SCRIPT Trial

    Professor Jon Emery, Professor Mark Jenkins, Professor Finlay Macrae, Professor Ingrid Winship, Dr Fiona Walter, Associate Professor Daniel Buchanan, Dr Patty Chondros, Dr Richard De Abreu Lourenco and Dr Jennifer McIntosh.


    Dr Jennifer McIntosh, Professor Jon Emery, Professor Mark Jenkins, Ms Anna Wood, Dr Tina Campbell and Ms Edweana Wenkart.


    Dr Jennifer McIntosh, Professor Jon Emery, Professor Mark Jenkins, Ms Anna Wood, Prof Patty Chondros, and Ms Edweana Wenkart, Professor Carlene Wilson, Professor Shanton Chang, Professor Jane Hocking, Dr Claire Nightingale.


    Dr Sibel Saya, Prof Jon Emery, Prof Mark Jenkins, Prof Ingrid Winship, A/Prof Daniel Buchanan, Prof Paul James, Dr Laura Forrest, A/Prof Jennifer McIntosh, Prof Melissa Southey, Dr Richard Allman, Dr Daniel Lee, Dr Amelia Smit, Prof Anne Cust, Dr James Dowty.

    The SITA Trial: Should I take aspirin?

    Professor Jon Emery, Ms Shakira Milton, Ms Sibel Saya, Dr Fiona Walter, Dr Lyndal Trevena, Dr Panagiota Chondoros, Professor Mark Jenkins, Dr Jennifer McIntosh and  Prof Finlay Macrae.

  • Research support

    The studies from the Cancer in Primary Care Research group are made possible due to dedicated grants from Victorian Cancer Agency Prevention and Screening Research Grant scheme and Cancer Australia.

  • Contact

    Ms Floriana La Rocca – Program Manager, Cancer in Primary Care Research

2022 Jon Emery Group

Professor Jon Emery's Cancer in Primary Care group

Exploring the role of primary care across the cancer continuum, including studies on cancer screening, cancer diagnosis and survivorship care.

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