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Background The Australian National Bowel Cancer Screening Program sends an immunochemical faecal occult blood test to Australians aged 50–74 years to screen for bowel cancer, but uptake is low (40.9%). The SMARTscreen trial demonstrated that sending a short messaging services (SMS) prompt from the participant's general practitioner (GP) increased the proportion of kit returns by 16.5%. This research aimed to determine the acceptability and feasibility of implementing SMARTscreen. Method SMARTscreen was a cluster randomized controlled trial set in 21 Australian general practices in regional Australia. Participants and general practice staff involved in the trial were included in this study. Acceptability and feasibility were measured quantitatively by calculating proportions of the SMS received, viewed, or opted out of, and qualitatively by interviewing people who sent and received the SMS. Results Of 2914 SMS sent, 2645 SMS (91%) were received by participants, 1128 (43%) people opened the weblink, and 59 (2%) people opted out of receiving future SMS. Interviews with general practice staff (n = 17) and participants (n = 18) found that sending and receiving the SMS was acceptable and feasible. The SMS was considered a low-burden activity that easily integrated into the clinic's workflow without impacting clinicians' time. Participants reported an increased intention to participate in screening, but some people worried the weblink was spam, and some suggested sending it out of working hours. Conclusion The SMS-based intervention was widely accepted by GP staff and participants. Future research should test the SMS with and without the weblink, and send the SMS at a more convenient time of the day/week. [ABSTRACT FROM AUTHOR]

Background: Ovarian cancer is commonly diagnosed symptomatically at an advanced stage. Better survival for early disease suggests improving diagnostic pathways may increase survival. This study examines literature assessing diagnostic intervals and their association with clinical and psychological outcomes. Methods: Medline, EMBASE, and EmCare databases were searched for studies including quantitative measures of at least one interval, published between January 1, 2000 and August 9, 2022. Interval measures and associations (interval, outcomes, analytic strategy) were synthesized. Risk of bias of association studies was assessed using the Aarhus Checklist and ROBINS-E tool. Results: In total, 65 papers (20 association studies) were included and 26 unique intervals were identified. Interval estimates varied widely and were impacted by summary statistic used (mean or median) and group focused on. Of Aarhus-defined intervals, patient (symptom to presentation, n = 23; range [median]: 7–168 days) and diagnostic (presentation to diagnosis, n = 22; range [median]: 7–270 days) were most common. Nineteen association studies examined survival or stage outcomes with most, including five low risk-of-bias studies, finding no association. Conclusions: Studies reporting intervals for ovarian cancer diagnosis are limited by inconsistent definitions and reporting. Greater utilization of the Aarhus statement to define intervals and appropriate analytic methods is needed to strengthen findings from future studies. [ABSTRACT FROM AUTHOR]

Simple Summary: The platelet count is an established marker of cancer. In healthy populations, platelet count varies by age and sex; despite that variation, a single reference range is used. This study aimed to identify age- and sex-specific upper thresholds for platelet count at which cancer should be considered in primary care, using audits of primary care-based clinical data in England, Canada, and Australia. Across all three cohorts, there was a clear upwards trend in cancer incidence with increasing platelet count for both sexes and at all age groups. The appropriate threshold will vary by country and will depend on local healthcare needs and priorities. As colorectal and lung cancers predominate, initial investigation may target these sites. Further investigation, depending on the patient's symptoms, could be CT imaging, endoscopy, or CA125. The platelet count, a component of the full blood count, has been identified as a useful diagnostic marker for cancer in primary care. The reference range for the platelet count is 150 to 400 or 450 × 109/L; this range does not account for natural variation in platelet count by age and sex. This study used three primary care cohorts from England, Canada, and Australia. Patients aged 40 years and over with a full blood count were included and stratified by age (in 10-year bands), sex, (male/female), and platelet count group. Cancer incidence within one year of the test date was estimated from linked registry data. In all three countries, there was a clear upwards trend in cancer incidence with increasing platelet count for both sexes and at all age groups. Lung and colorectal were the most common sites. These results have important implications for the international application of this work; analysis of local health datasets will be crucial to determining appropriate thresholds. Appropriate upper thresholds will depend on local populations, healthcare needs, and priorities. Further research is needed to assess the likely impact of new recommendations on the healthcare system, on cancer outcomes, and patient benefit. [ABSTRACT FROM AUTHOR]

Background: Australia has one of the highest incidences of colorectal cancer (CRC) worldwide. The Australian National Bowel Cancer Screening Program (NBCSP) is a best-practice, organised screening programme, but uptake is low (40.9%) and increasing participation could reduce morbidity and mortality associated with CRC. Endorsement by GPs is strongly associated with increasing screening uptake. Aim: This study (SMARTscreen) aimed to test whether a multi-intervention short message service (SMS) sent by general practices to 50–60-year-old patients who were due to receive the NBCSP kit would increase NBCSP uptake, by comparing it with usual care. Design and setting: A stratified cluster randomised controlled trial was undertaken, involving 21 Australian general practices in Western Victoria, Australia. Method: For intervention practices, people due to receive the NBCSP kit within a 6-month study period were sent an SMS just before receiving the kit. The SMS included a personalised message from the person's general practice endorsing the kit, a motivational narrative video, an instructional video, and a link to more information. Control practices continued with usual care, comprising at-home testing with a faecal immunochemical test (FIT) through the NBCSP. The primary outcome was the between-arm percentage difference in uptake of FIT screening within 12 months from randomisation, which was estimated using generalised linear model regression. Results: In total, 39.2% (1143/2914) of people in 11 intervention practices and 23.0% (583/2537) of people in 10 control practices had a FIT result in their electronic health records — a difference of 16.5% (95% confidence interval = 2.02 to 30.9). Conclusion: The SMS intervention increased NBCSP kit return in 50–60-year-old patients in general practice. This finding informed a larger trial — SMARTERscreen — to test this intervention in a broader Australian population. [ABSTRACT FROM AUTHOR]