Case study: Cancer Council Victoria’s 2022 Pharmacy Bowel Cancer Screening Project

The National Bowel Cancer Screening Program (NBCSP) mails people aged 50 to 74 a free Faecal Occult Blood Test (FOBT) every two years to screen for bowel cancer. However, between 2019 and 2020 only 40.9 per cent of Australians and 43.9 per cent of Victorians participate.

In 2022 Cancer Council Victoria undertook its first Pharmacy Bowel Cancer Screening Project in Mildura, Victoria. Over the course of six weeks, three local pharmacies helped raise awareness about the importance of bowel screening to their customers.

Participation is even lower in some areas of Victoria. To increase community awareness and participation in the NBCSP in regional Victoria, a campaign encouraging conversations about the NBCSP between customers and staff in three Mildura pharmacies was implemented over eight weeks in October and November 2022.

This model included four strategies:

• The campaign display
• Handing out brochures
• Starting conversations
• Supporting customers to re-order FOBTs.

These strategies were underpinned by increasing staff knowledge about the NBCSP and their confidence to start conversations as well as sustaining their motivation to continue conversations after the campaign.

The effectiveness of the model in raising awareness and encouraging participation for the community was measured by recording the number of conversations and FOBTs ordered. Outcomes for staff were measured using an online staff training survey and a post campaign staff survey. The acceptability and feasibility of the model was explored in qualitative interviews with staff members after the campaign.

The displays were seen by all pharmacy customers over eight weeks. These were the results:

• More than 4500 brochures were handed out.
• A total of 322 conversations were held, with 205 (67 per cent) in the eligible age range.
• 95 people were supported to re-order a FOBT.

Staff from pharmacies felt the campaign was acceptable both to staff and community members as pharmacies are seen as alternative health hubs and it strengthens relationships between the pharmacist and community. Sharing health messages in a pharmacy setting was also seen as feasible.

The 19 staff who were trained reported that it increased their knowledge and confidence. All seven respondents to the post campaign survey reported that this was sustained across the campaign. Motivation to continue conversations outside the campaign was mixed as the display and brochures were important to starting a conversation about bowel screening.

The pharmacy model was effective in generating outcomes for community and staff, it was acceptable to pharmacies and customers and feasible to implement. Based on this evidence, the pharmacy model should be refined based on the implementation learning and scaled up to other regions.

The Mildura region has lower than state-average participation in the NBCSP. To increase participation in the NBCSP in this area, Cancer Council Victoria harnessed the role of pharmacies as health hubs and pharmacists as trusted health experts.

Lee-Ching Tan, Proprietor of Chemist Warehouse – Mildura Central Shopping Centre, explains the pharmacy’s involvement in the project.

Why did you want to take part in this project? 

Our pharmacy wanted to participate in this project to give staff the opportunity to increase their knowledge about the National Bowel Cancer Screening Program. I thought this opportunity would also help to increase and improve professional relationships with customers.    

What strategies did you use instore to promote awareness about bowel screening to customers?

As part of our grant, Cancer Council Victoria supplied us with brochures that we could hand out and put in script bags that explained how to do the bowel screening kit. We also received promotional materials to help decorate the store. These included:

• toilet rolls and toilet seat
• 'poo' stress balls and
• 'toilet' toys.

The bright display always caught the attention of customers, and along with handing out brochures, it helped to start the conversation on bowel cancer screening.  

How did your pharmacists incorporate promoting bowel cancer screening into their daily in-store routines? 

We identified eligible customers when we were dispensing (checking their age in dispensing history), put a brochure and note in customer's basket so that prompted pharmacy assistant to get the pharmacist to speak with the customer.

We also helped customers re-order bowel screening kits for those who were eligible). The National Cancer Screening Register website was very easy and straightforward to use.

How did taking part in this project help benefit your business? 

By participating in this project, it helped to improve the professional relationship with the customers. It also helped to improve the image of the business.

The pharmacy is a place they can come and ask questions about these health topics and get help to re-order a free kit if needed. Being able to provide this service is important especially in regional areas where access to some other healthcare providers can be limited.

What kind of feedback did you get from your customers about the bowel cancer screening promotion? 

Customers found this promotion acceptable and relevant. It was a good reminder for themselves and/or family members to use the screening test when they receive it instead of putting it away. Customers also found it helpful that we could help them to re-order if they needed to.

Some customers also found the 'poos' and 'toilet seat’ display funny, but in a good way as it helped start the conversation about something which is very serious.  

What was the feedback from your staff about the bowel cancer screening project? 

Initially, some staff were uncomfortable to talk to customers regarding bowel cancer screening due to personal reasons or confidence. Younger less experienced pharmacy retail staff had the least confidence to initiate discussions on this health topic. However, the training and support provided by Cancer Council Victoria, along with resources and displays, helped build everyone’s knowledge and confidence.

Other staff were very proactive and felt that this was a very good campaign and actively promoted the project. Staff also felt the brochure was an effective resource to give to customers during the promotion.  

Would you run a bowel cancer screening project again in the future? 

We would like to continue promoting the bowel cancer screening program. We think an important part of this would having resources and display materials as those aspects helps to prompt customers and makes initiating a conversation easier.  

Would you encourage other pharmacies to take part in future bowel cancer screening projects? 

Yes, especially if they are in the regional area where access to some types of healthcare is limited for the community.

For more information about the Pharmacy Bowel Screening Project contact Cancer Council Victoria at certification@cancervic.org.au.