The National Bowel Cancer Screening Program invites eligible Australians to screen every two years, yet bowel screening participation in Australia remains well below the levels achieved by the breast and cervical programs. For a practice, the gap shows up as patients who receive a kit in the mail and then disappear from view until the next round arrives. The lost opportunity is a preventable cancer missed and a Medicare-funded consultation not used.
A practice can move the needle by treating the mailed kit as the start of a recall sequence, not the end. Most participants who complete the test do so within the first weeks of receiving it; the majority who do not return it simply need a prompt. That prompt is easiest to deliver when your practice can identify who has received a kit and who has not returned it, then contact them directly.
How to identify patients overdue for bowel screening
Your recall list begins with eligibility. The National Bowel Cancer Screening Program (NBCSP) is open to Australians aged 45 to 74. Patients aged 50 to 74 are mailed a free kit automatically every two years. Patients aged 45 to 49 are not — they have to request their first kit, after which the two-year cycle starts for them too. Anyone in the eligible range can also ask their doctor for a kit. The test itself is an immunochemical faecal occult blood test (iFOBT), and a positive result triggers a Medicare-rebated follow-up consultation.
What the program does not do is tell your practice who among your patients has received a kit, who has returned it, and who has not. That information lives in the National Cancer Screening Register, and while general practices can access it, the workflow to query and then act on that data is not built into a standard practice management system. Practices that close this loop see the biggest lift in participation.
A practical starting point is to query your practice management system for patients in the eligible age range with no recorded NBCSP result in the past two years. That cohort is your first recall list. From there, you can refine: patients who have never screened, patients who screen irregularly, and patients whose last result was positive and need follow-up. The register of overdue patients becomes the basis of a systematic outreach program rather than a reactive response to whatever arrives in the mail.
Common questions
Why do so many eligible patients not complete bowel screening?
The most common reasons are that patients do not understand the importance of screening when they have no symptoms, the kit arrives at an inconvenient time and is set aside, or they are unsure how to use it. A brief message from a trusted practice — a nurse or GP — can address all three barriers at once.
Can a practice remind patients about the NBCSP kit?
Yes. The program expects participants to receive reminders, and a general practice recall to a patient on its list is part of normal clinical care. The key is to frame the message as a follow-up to a test they have already received, not as a new order.
What counts as screening for bowel cancer in a general practice setting?
For the NBCSP, screening means completing the mailed iFOBT kit. Diagnostic colonoscopy following a positive iFOBT is not counted as screening; it is investigation. Practices sometimes conflate the two when measuring their own screening rates, which understates the true gap.
Current as at 7 August 2026. MBS items and program rules change — check MBS Online and the National Cancer Screening Register before relying on any figure here.