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Additional file 4. SCRIPT study consent form.

Additional file 3. Example colorectal cancer risk report and screening recommendations for a participant’s GP at moderate risk in the SCRIPT study.

Additional file 1: Supplementary Table 1. ASSET Health-Related Quality of Life Outcomes (PedsQL Cancer Module and HUI3). Supplementary Table 2. Parents’ emotional well-being (ET). Supplementary Table 3. COG vs. iBFM Protocol Group Health-Related Quality of Life Comparisons (HUI3, PedsQL & PedsQL Nausea, Pain & Procedural Anxiety subscales). Supplementary Table 4. COG vs. iBFM Protocol Group Health Related Quality of Life Comparisons (PedsQL Anxiety, Worry, Cognitive Functioning, Physical appearance & Communication subscales). Supplementary Table 5. COG vs. iBFM Protocol group parental emotional well-being comparisons (ET).

Additional file 1. Standard cancer risk reduction information provided to control participants in the SCRIPT study.

Additional file 2. Example colorectal cancer risk report and screening recommendations for a participant’s GP at moderate risk in the SCRIPT study.

Additional file 2: Data Table 1. HUI3 Data. Data Table 2. PedsQL Cancer Data. Data Table 3. Emotion Thermometer Data.

BackgroundHome-based management of low-risk febrile neutropenia (FN) is safe, improves quality of life and reduces healthcare expenditure. A formal low-risk paediatric program has not been implemented in Australia. We aimed to describe the implementation process and evaluate the clinical impact.MethodThis prospective study incorporated three phases: implementation, intervention and evaluation. A low-risk FN implementation toolkit was developed, including a care-pathway, patient information, home-based assessment and educational resources. The program had executive-level endorsement, a multidisciplinary committee and a nurse specialist. Children with cancer and low-risk FN were eligible to be transferred home with a nurse visiting daily after an overnight period of observation for intravenous antibiotics. Low-risk patients were identified using a validated decision rule, and suitability for home-based care was determined using disease, chemotherapy and patient-level criteria. Plan-Do-Study-Act methodology was used to evaluate clinical impact and safety.ResultsOver 18 months, 292 children with FN were screened: 132 (45%) were low-risk and 63 (22%) were transferred to home-based care. Compared with pre-implementation there was a significant reduction in in-hospital median LOS (4.0 to 1.5 days, p ConclusionThis program significantly reduces in-hospital LOS for children with low-risk FN. Ongoing evaluation will inform sustainability, identify areas for improvement and support national scale-up of the program.

Participant information sheet/consent form. (DOCX 55 kb)

Medicare consent form. (DOCX 33 kb)

Background Polygenic risk scores (PRSs) can predict the risk of colorectal cancer (CRC) and target screening more precisely than current guidelines using age and family history alone. Primary care, as a far-reaching point of healthcare and routine provider of cancer screening and risk information, may be an ideal location for their widespread implementation. Methods This trial aims to determine whether the SCRIPT intervention results in more risk-appropriate CRC screening after 12 months in individuals attending general practice, compared with standard cancer risk reduction information. The SCRIPT intervention consists of a CRC PRS, tailored risk-specific screening recommendations and a risk report for participants and their GP, delivered in general practice. Patients aged between 45 and 70 inclusive, attending their GP, will be approached for participation. For those over 50, only those overdue for CRC screening will be eligible to participate. Two hundred and seventy-four participants will be randomised to the intervention or control arms, stratified by general practice, using a computer-generated allocation sequence. The primary outcome is risk-appropriate CRC screening after 12 months. For those in the intervention arm, risk-appropriate screening is defined using PRS-derived risk; for those in the control arm, it is defined using family history and national screening guidelines. Timing, type and results of the previous screening are considered in both arms. Objective health service data will capture screening behaviour. Secondary outcomes include cancer-specific worry, risk perception, predictors of CRC screening behaviour, screening intentions and health service use at 1, 6 and 12 months post-intervention delivery. Discussion This trial aims to determine whether a PRS-derived personalised CRC risk estimate delivered in primary care increases risk-appropriate CRC screening. A future population risk-stratified CRC screening programme could incorporate risk assessment within primary care while encouraging adherence to targeted screening recommendations. Trial registration Australian and New Zealand Clinical Trial Registry ACTRN12621000092897p. Registered on 1 February 2021.