None listed
Conditions
Brief summary
This study will examine the impact of the National Bowel Cancer Screening Program (NBCSP) on colorectal cancer outcomes for people over the age of 50 with severe mental illness. Who is it for? This retrospective study will be looking at data on people aged 50-74 and who have participated in the NBCSP, with or without severe mental illness. We will also be consulting with people with severe mental illness and their carers on barriers to screening and optimal care. Study details This is a data linkage study of multiple Commonwealth datasets: NBCSP, Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, Australian Cancer Database and the National Death Index. Data linkage with NSW Cancer registry and hospital data will also be used. This research project is directly focused on identifying where access and/or treatment disparities exist along the colorectal cancer care pathway for people with severe mental illness in order to improve access and service utilisation, and ultimately to improve cancer survival for this very disadvantaged group.
Interventions
We are assessing the impact of the National Bowel Cancer Screening Program (NBCSP) by comparing participation rates of people with and without Severe Mental Illness (SMI) and looking at health outcomes. We will be using data collected from Aug 2006 - latest available. We are linking data using Commonwealth data (NBCSP, Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, Australian Cancer Database & the National Death Index) to compare bowel cancer screening participation in people with SMI to those from the general population. We will additionally link these to the NSW cancer registry and hospital data to examine care pathways from diagnosis through treatment and end-of-life care. We will also conduct a consultation with people with experience of SMI and Colorectal cancer and people with SMI in peer support roles who can provide their perspective on the barriers faced by people with SMI to gaining timely screening, diagnosis and optimal care. These participants will be recruited from New South Wales consumer organisations and organisations with a strong focus on provision of peer support and advocacy. We will use a semi structured group interview schedule to facilitate discussion of a single focus group of 15 people. The group will consist of both people with lived experience who have direct experience of bowel cancer (n=10), as well as other people with lived experience who have supported people in this situation – as peer support workers or in other consumer advocacy/support roles (n=5). We will use this qualitative arm of the study to further develop our understanding of the quantitative findings. The consultation will also develop ideas on how to improve access to care.
Sponsors
Eligibility
Inclusion criteria
National cohort People with SMI: We will define people as having SMI using PBS data. Those who have been dispensed at least two prescriptions for authority-only medications used specifically for SMI since 01/07/2002 (the commencement of the PBS dataset). We will include only people aged 50-74 years at 01/01/2006 or who turn 50 after this date or become Medicare eligible (and were 50-74 years) after this date. NSW cohort All men and women aged 50-74 years, registered in the NSW Cancer Registry with a new diagnosis of cancer of the colon or rectum diagnosed after 01/01/2006 to the latest available. Comparator group The AIHW will randomly select a sample of people on the Medicare Enrolments File selecting 1 in 4 people from the entire population aged 50-74 years at 01/01/2006 or who turn 50 after this date or become Medicare eligible (and were 50 years or over) after this date. This group will consist of people who have not been dispensed a prescription for one of the specified PBS medicines between 1/7/2002 to latest available. Focus group The group will consist of both people with lived experience who have direct experience of bowel cancer (n=10), as well as other people with lived experience who have supported people in this situation – as peer support workers or in other consumer advocacy/support roles (n=5).
Exclusion criteria
People under the age of 50 and over the age of 74 at the time of their colonoscopy. People who have not been diagnosed with SMI ie: who have not been dispensed at least two prescriptions for authority-only medications used specifically for SMI since 01/07/2002.