Roughly one in five patients referred for bowel investigation never make it to colonoscopy (van de Veerdonk W et al., Prev Med, 2019). Some withdraw. Some are still waiting months later. Either way, the referral protocol has cracks, and patients are falling through them.
This isn’t a criticism of your triage decisions. It’s a description of a system under strain, where equivocal symptoms, patient reluctance, and colonoscopy capacity all collide in the same consult.
The follow-through problem is real, and it’s measurable
International data puts non-attendance at colonoscopy or FOBT follow-up at close to 20% (van de Veerdonk W et al., Prev Med, 2019). Australian screening data tells a similar story: in 2021, 85.5% of people with a positive FOBT result had a follow-up colonoscopy recorded within 360 days (Cancer Australia, National Cancer Control Indicators). That means roughly one in seven missed the next diagnostic step within a full year.
Some of that gap is patient reluctance. Some is hospital triage. Some is uncertainty about how urgent a case really is. None of it is solved by current referral practice. A tool to prioritise patients based on bowel cancer risk could help with all of these.
The three scenarios below are examples of the kind of presentations GPs see every week.
Picture them as your own patients.
When symptoms don’t point clearly one way
A patient in his 50s comes in with a little blood in the stool and a recent change in bowel habit. A positive FOBT follows. It could be haemorrhoids, or it could be bowel cancer. You want him to have a colonoscopy. He’s frightened by the investigation, worried about a long wait for colonoscopy, and asks if there’s anything else you can do.
This is where ColoSTAT® earns its place. It’s a cancer-specific test, with a high sensitivity for bowel cancer, not a general bleeding marker. Offered alongside your referral, this man’s positive ColoSTAT® result gives you evidence to escalate: not “let’s wait and see”, but “let’s get it checked out.” Including the results in your referral letter can give the hospital a reason to book this gentleman in for an urgent colonoscopy. That could be what drives diagnosis at an early, more treatable stage.
Takeaway: Rather than replacing your clinical judgement, ColoSTAT® sharpens it, and could shorten the time between symptom and diagnosis and ultimately treatment.
When patient frailty is a consideration
An elderly patient presents with abdominal pain and swelling. In their consult, they report an inability to empty their bowels. You know this patient should undergo a colonoscopy. But both of you are wary of colonoscopy — the prep, the sedation, the physical toll. Neither of you want to put them through it without good reason.
Offer ColoSTAT® as a non-invasive first step. A positive result changes the conversation. It gives you and your patient shared confidence that a colonoscopy is necessary. The procedure goes ahead, finds cancer, and treatment starts. Nobody second-guesses the decision afterwards.
Takeaway: For frailer patients, a positive ColoSTAT® result gives you and your patient shared confidence that a colonoscopy is valuable.
When the wait is the hardest part
A patient in her 50s presents with abdominal pain and symptoms of anaemia. You refer her for colonoscopy, but being a low-risk patient could mean months of waiting. She’s distressed at the thought of carrying a “maybe cancer” status for that long.
You provide a ColoSTAT® request alongside the referral, in the same consult. Her ColoSTAT® result comes back negative in February. Her colonoscopy, in July, confirms it. Because of ColoSTAT®’s high Negative Predictive Value (NPV) you and your patient can be confident the diagnosis is unlikely to be cancer, reducing her anxiety while she waits for a colonoscopy.
Takeaway: The queue moves at the same pace either way. What changes is what your patient carries while she’s in it.
Where ColoSTAT® sits in your triage toolkit
ColoSTAT® is a NATA-accredited blood-based test developed from CSIRO research,. It’s intended for symptomatic patients aged 45–84 being assessed for bowel cancer. Across all stages, sensitivity sits at 90.3%, with 90.7% for early-stage disease — the stage where treatment outcomes are best. Negative predictive value is 99.4%, meaning you should have confidence in a negative result.
ColoSTAT® is not a replacement for colonoscopy. It’s a decision-support tool that sits ahead of it: prioritising urgent cases, supporting the decision to proceed in equivocal or higher-risk patients, reassuring distressed patients waiting for a definitive diagnosis, and giving reluctant patients a reason to stay engaged with the pathway, rather than dropping out.
Most referrals still won’t find cancer
That’s worth remembering, and worth conveying to your patients. What ColoSTAT® changes is how confidently you triage the referrals that matter most, and how your patients experience the wait along the way.
If ColoSTAT® isn’t part of your practice yet, explore our website to see how the ordering process works, or speak with your local Rhythm Biosciences representative about incorporating it into your referral pathway.
