New resource to address perceived age bias
Never2Young CPD series – RACGP & ACRRM accredited
- Early-onset bowel cancer patients perceive age bias as a barrier to diagnosis.
- Younger people may spend between 3 months and 5 years seeing multiple doctors before diagnosis. They may make 10 or more visits to GPs.
- Risk of bowel cancer diagnosis before age 40 has more than doubled since 2000.i
Friday 28 June, Sydney: Bowel Cancer Australia today launched the Never2Young CPD series, a range of GP educational activities to help overcome perceived age bias by people under age 50 diagnosed with bowel cancer.
The series was developed in response to requests from early-onset bowel cancer advocates and recent Australian research which cited the mounting imperative for GPs to receive more information and clinical guidance on early-onset bowel cancer specific diagnosis.
Published in BMJ Openii and BMC Primary Careiii, the studies found younger people may spend between 3 months and 5 years seeing multiple doctors before diagnosis. They may make 10 or more visits to GPs.
Patients perceived their GPs’ low suspicion of cancer given their age as an age bias that shaped the nature of clinical assessments, influenced the investigations conducted and referrals given, and created tensions between patients and doctors which obstructed shared decision-making.
Bowel Cancer Australia CEO Julien Wiggins said: “Limited clinical awareness of early-onset bowel cancer presents a challenge for young people seeking diagnosis.”
“Younger patients are often overlooked for bowel cancer which was the motivation for developing this important educational resource,” he added.
The Never2Young CPD series is an approved activity of The Royal Australian College of General Practitioners (RACGP) and The Australian College of Rural and Remove Medicine (ACRRM). The educational activities total 2.5 CPD hours. Upon completion participants will be able to:
- Quantify the risk and impact of bowel cancer in younger adults in Australia.
- Identify red flag signs and symptoms of and risk factors for bowel cancer in younger adults and prompt referral for further investigation.
- Promote and advocate the recent changes to screening guidelines to increase the uptake in
younger adults.
The series includes two interactive virtual clinics based on patient lived experiences representative of two age groups: people aged under 30 and people aged 30 to 49.
From late July, Measuring Outcome (MO) hours can also be earned with two audit activities focused on early-onset bowel cancer in general practice.
Early-onset bowel cancer patients differ from late-onset bowel cancer patients in their diagnostic trajectories; time to diagnosis can be 60% longer with a greater number of missed diagnostic opportunities, and younger people are more likely to be diagnosed in later stages of the disease.
Late-stage diagnosis increases the likelihood of aggressive treatment with physical, psychosocial, and quality of life outcomes that are uniquely challenging for this under-50 patient population, especially with regards to fertility and ostomy management.
International analysis of nearly 25 million patients younger than 50 published in JAMA Network Openiv, found nearly half of individuals (45%) presented with blood in the stool, 40% presented with abdominal pain, and more than one-quarter (27%) presented with altered bowel habits.
Blood in the stool and abdominal pain were associated with a 5 to 54-fold and 1.3 to 6-fold increased likelihood of early-onset bowel cancer, respectively.
Bowel Cancer Australia is dedicated to championing what matters most to people impacted by bowel cancer, such as awareness of early-onset bowel cancer and perceived age bias, and empowering everyone affected to live their best life.
1,716 Australians are diagnosed with bowel cancer under age 50 each year and it is the deadliest cancer for Australians aged 25-44.
ii Lamprell K, Fajardo-Pulido D, Arnolda G, et alThings I need you to know: a qualitative analysis of advice-giving statements in early-onset colorectal cancer patients’ personal accounts published onlineBMJ Open 2023;13:e068073. doi: 10.1136/bmjopen-2022-068073
iii Lamprell, K., Pulido, D.F., Arnolda, G. et al. People with early-onset colorectal cancer describe primary care barriers to timely diagnosis: a mixed-methods study of web-based patient reports in the United Kingdom, Australia and New Zealand. BMC Prim. Care 24, 12 (2023). https://doi.org/10.1186/s12875-023-01967-0
iv Demb J, Kolb JM, Dounel J, et al. Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024;7(5):e2413157. doi:10.1001/jamanetworkopen.2024.13157
Contact details:
For an interview with a medical expert or patient contact:
Stephanie Bansemer-Brown – Bowel Cancer Australia
stephanie@bowelcanceraustralia.org | 0412 915 797