If your practice is still working from a bowel screening recall list built on a two-year reminder cycle, you are missing patients. The National Bowel Cancer Screening Program invites eligible Australians by mail, but a practice that waits for the kit to arrive, then waits two years from the date it was mailed, will have gaps. An accurate overdue bowel screening patient list starts from the date the patient last completed a test, not from when they were invited.
The NBCSP mails invitations and kits to Australians aged 50–74 every two years. Eligible patients aged 45–49 can request a kit, and once the first kit is completed they enter the same two-year cycle. For a full picture of how the program works, see our National Bowel Cancer Screening Program workflow guide. Yet many practices set a recall on the invitation date or on the date the kit was ordered, which means a patient who completes their test late — or whose result arrives late — falls through the crack. The fix is to build your list from the result date recorded in the patient record, or from the date the practice last coded a screening event, and then to reconcile both against the National Cancer Screening Register to catch the patients whose result never made it back into your PMS.
Why your current query is probably incomplete
Most recall queries in Australian general practice are written with three blind spots.
First, they assume the NBCSP invitation is the trigger. It is not. The program mails kits on a rolling basis by birth month, but the clock for your recall restarts when the patient completes the test, not when the letter arrives. If you set a reminder two years from the invitation date, a patient who takes four months to return the kit will be recalled four months late — or missed entirely if your query only looks for patients due in a fixed month.
Second, they rely on a single coded entry. Bowel screening results arrive as pathology, as a letter, or as a patient-reported outcome. Some practices code the event as "FOBT positive", "FOBT negative", or "iFOBT" under a preventive activity. Others file the letter and do not code. If your query only searches for a specific code or text string, it will miss the patients whose result lives in a scanned PDF or a nurse's note.
Third, they do not cross-check the National Cancer Screening Register. The NCSR is the source of truth for NBCSP participation. A patient may have completed a test at another practice, or the result may have been recorded by a different provider and never forwarded to you. Your PMS cannot know this unless you look it up.
A query that catches nearly everyone
Build your overdue bowel screening patient list in two passes: first inside your PMS, then against the Register.
Pass 1: inside Best Practice, MedicalDirector or Zedmed
Start with age. The NBCSP is open to Australians aged 45 to 74. Patients aged 50 to 74 are mailed a kit automatically; patients aged 45 to 49 have to request their first one. Include both cohorts. If you exclude the 45–49 group, you are leaving out exactly the patients who get no kit unless someone prompts them.
Next, decide on your date logic. You want patients whose last recorded NBCSP event was more than two years ago, or who have never had one recorded. Do not use the invitation date; use the earliest of:
- The date a pathology result for iFOBT/FIT was coded or filed
- The date a nurse or GP recorded "bowel screening completed" or equivalent
- The date a patient reported completing the test (with a note in the record)
If none of those exist, the patient has no recorded event and should appear on your list as overdue if they are in the eligible age range.
In practice, the query looks like this in plain terms: find patients aged 45–74 where the date of the most recent bowel screening result is either missing or older than two years. That single rule catches more patients than a query tied to invitation dates or to a single code.
Each PMS expresses this differently. In Best Practice, you would search for patients in the age range with no consultation containing your chosen screening codes in the last two years. In MedicalDirector, you might use a recall query that looks for the absence of a preventive item in the interval. In Zedmed, a similar saved search or recall group will do it. Describe the requirement to your PMS administrator as patients aged 45–74 with no recorded NBCSP completion in the last two years, and let them translate it to the local syntax.
Pass 2: reconcile with the National Cancer Screening Register
Once you have your internal list, run it against the NCSR. You need a healthcare provider access level to the Register. Log in with your HPOS credentials, navigate to the screening history, and check each patient's last recorded screening date.
What you will find is three categories:
| Category | What it means | What to do |
|---|---|---|
| Last screening date is recent and not in your PMS | The patient did the test elsewhere or the result was not filed | Update your PMS with the date and mark the patient as up-to-date |
| Last screening date is recent and matches your PMS | Your data is current | Leave the patient off the recall list |
| Last screening date is old or missing | The patient is overdue and needs recall | Add or keep them on your overdue bowel screening patient list |
This reconciliation is the difference between a list that looks accurate and one that actually is. It is also the part most practices skip, because it takes time. The shortcut is to run a batch check for your entire eligible cohort once a quarter and then maintain it with individual lookups as patients present.
The cohort most often missed
There are three groups that routinely drop off recall lists, and all of them require a deliberate fix.
First, patients who completed a test but whose result never reached the practice. This happens when a patient does the test at a different GP, or when the pathology result is misfiled, or when the patient completes the kit but the practice does not record it. The NCSR reconciliation catches these.
Second, patients aged 45–49. Because the NBCSP mails automatically only from 50, many practices forget the younger cohort entirely. Yet they are eligible from 45, and once they have completed one test they move onto the same two-year cycle as everyone else. This group is the clearest case where a practice recall does work the program's mailout will never do.
Third, patients whose address on the Register is out of date. The NBCSP posts a physical kit. A patient who has moved and updated their address with your practice but not with Medicare will be counted as invited and will never see the kit. These patients look identical to non-responders in your data, so treat a long run of unreturned kits as a prompt to check the address rather than as a refusal.
Turning the list into a recall
Once you have an accurate overdue bowel screening patient list, the next step is to segment it. Not every patient needs the same message or the same channel.
Start with the patients who have never had a recorded screening event. They need education as well as a recall: what the test is, why it matters, and how simple it is to do at home. A letter or a long-form SMS works better here than a short message.
Then take the patients who are simply overdue. They know the drill. A short SMS with a clear call to action is usually enough: It is time for your next bowel screening test. A kit has been posted, or you can request one from the National Cancer Screening Register. Reply STOP to opt out.
Check the current request line and web address on the National Cancer Screening Register site before you put either into a template — do not copy a number out of a blog post, including this one, into a message you send to patients.
Finally, flag the patients who have previously been sent multiple recalls with no response. These patients may need a different approach: a phone call from a nurse, a script that addresses barriers like embarrassment or fear of a positive result, or an offer to provide the kit in person at the practice.
Building a repeatable workflow
Doing this once is not enough. Screening programs only work if the recall is continuous. The practices that sustain high participation treat recall like a production line, not a one-off project.
Set a quarterly cycle. In the first week, run the query and the NCSR reconciliation. In the second week, send the recalls. In the third week, follow up the non-responders. In the fourth week, update your records with the new completions and file the lessons.
Automate what you can. If your PMS supports saved searches or recall groups, keep them live. If it allows a date-based trigger, set it to flag patients two years and one month after their last recorded completion, so you have a buffer to catch late results.
Most importantly, assign an owner. Recall lists that are nobody's job become nobody's problem. A nurse or a practice manager with a standing calendar invite to run the process each quarter will keep it alive.
The records you need to keep
Medico-legally and for accreditation, you need to be able to show:
- The criteria you used to generate the list
- The date you ran the query
- The messages you sent and on what date
- The responses you received and the actions you took
A simple spreadsheet is enough: patient ID, last recorded screening date, recall date, recall method, response, and outcome. This is your audit trail, and it is what a RACGP surveyor or a coroner will ask for if there is ever a question about why a patient was not recalled.
Common questions
How often should we run this query?
Every three months for the full eligible cohort. That gives you a rolling window to catch patients whose results arrive late or whose status changed. Monthly is better if you have the capacity, but quarterly is the practical minimum to stay on top of the program.
Why not just rely on the NBCSP invitations?
The NBCSP mails invitations, but it does not follow up non-responders. Practices that rely on the mail-out alone have participation rates well below the national average. As we noted in bowel screening participation in Australia and what your practice can do, active recall by the practice raises uptake, but the program is designed to be supplemented by general practice, not to replace it.
Our PMS does not have a dedicated bowel screening field. How do we code it?
Use whatever coding system your practice already uses for preventive activities, but use it consistently. Some practices use a specific clinical code for iFOBT; others use a free-text note. The key is that every completion is recorded in the same place and in the same way, so your query can find it. If you do not have a standard, pick one and document it in your practice manual.
How do we handle patients who say they have done the test but we have no record?
Check the NCSR first. If the Register shows a recent screening, update your PMS and mark the patient as current. If the Register has no recent record, ask the patient for the date and the result, and file it. If they cannot recall, offer to request a kit and start the cycle again. Never remove a patient from recall on their word alone unless you can verify it.
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.