GP Vivas · gastrointestinal-health
Bowel cancer screening — structured viva
Structured oral on bowel cancer screening: the positive kit that must never be repeated, FIT cut-offs as policy, adenoma detection rate as a survival variable, the symptomatic pathway boundary, and the practice systems that close both participation and follow-up gaps.
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Study tools
Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'Your practice's positive-screen patients wait three months for colonoscopy, your endoscopist of choice has never heard of adenoma detection rate, and a third of invited patients bin the kit. Fix all three — with evidence.' The viva branches through follow-up urgency, test performance, colonoscopy quality, symptomatic-pathway boundaries and uptake.
Stem
You are the GP. A partner argues that bowel screening generates more work than it is worth — "positives, scopes, worries". [6]
References8ShowHide
- [1]Hewitson P, Glasziou P, Watson E, Towler B, Irwig L Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (hemoccult): an update. American Journal of Gastroenterology, 2008.PMID 18479499
- [2]Corley DA, Jensen CD, Marks AR, et al. Adenoma detection rate and risk of colorectal cancer and death. New England Journal of Medicine, 2014.PMID 24693890
- [3]Pin Vieito N, Zarraquiños S, Cubiella J High-risk symptoms and quantitative faecal immunochemical test accuracy: Systematic review and meta-analysis. World Journal of Gastroenterology, 2019.PMID 31148909
- [5]Selby K, Jensen CD, Lee JK, et al. Influence of Varying Quantitative Fecal Immunochemical Test Positivity Thresholds on Colorectal Cancer Detection. Annals of Internal Medicine, 2018.PMID 30242328
- [6]Levin TR, Corley DA, Jensen CD, et al. Effects of Organized Colorectal Cancer Screening on Cancer Incidence and Mortality in a Large Community-Based Population. Gastroenterology, 2018.PMID 30031768
- [11]Hsu WF, Chang CY, Chang CC, et al. Risk of colonoscopy-related complications in a fecal immunochemical test-based population colorectal cancer screening program. Endoscopy, 2022.PMID 33271603
- [12]Shanahan JJ, LeBlanc DM, Courage ER, et al. Characteristics of Interval Colorectal Cancer: A Canadian Retrospective Population-Level Analysis from Newfoundland and Labrador. Current Oncology, 2022.PMID 36547130
- [15]Smith SJ, Moorin R, Tadesse D, et al. Interval Cancer Characteristics, Staging and Survival Among National Bowel Cancer Screening Program Participants, Western Australia, 2018: A Retrospective Observational Cohort Study. The Medical journal of Australia, 2026.PMID 41629194