Monday Lunch Live
10 August 2026 (Video recording below)
The same gastrointestinal symptoms get investigated very differently across Australian general practice
Every day, GPs face a hard problem: gastrointestinal symptoms like abdominal pain, reflux, and change in bowel habit are very common, but rarely signal cancer. Who gets investigated, and does it depend on the patient or the practice?
Drawing on two published linked-data studies of more than 114,000 patients across 130+ Victorian general practices, this seminar reveals substantial and consistent variation in how colorectal and oesophagogastric cancer symptoms are investigated. The studies measured a defined set of investigations (pathology, imaging, upper GI endoscopy or colonoscopy, and specialist referral) recorded at the encounter.
For some symptoms, a large share of presentations had none of these recorded. Even so, the variation is clear: older and more disadvantaged patients were investigated less often, and two patients with similar characteristics could have up to an 8.6-fold difference in their odds of investigation depending on which practice they attended.
This is not about individual GPs making poor decisions; it reflects genuinely difficult judgement calls in a system lacking structural support. Attendees will leave with a clear evidence base on diagnostic variation and equity, and a practical discussion of decision-support tools, referral pathways, and reforms to make cancer diagnosis fairer and more consistent.
Chair
Associate Professor Dan Buchanan
Principal Research Fellow, Head of the Colorectal Oncogenomics Group, Department of Clinical Pathology, University of Melbourne
A/Prof Dan Buchanan is Head of the Colorectal Oncogenomics Group in the Department of Clinical Pathology and Collaborative Centre for Genomic Cancer Medicine at the University of Melbourne. He leads a diverse, multi-disciplinary research program focused on determining the causes of early-onset colorectal cancer and polyposis using integrative multi-omic and molecular pathology epidemiology approaches applied to world-leading studies. He holds leadership roles as an InSiGHT council member, co-PI of the Colon Cancer Family Registry, as the PI of the Genetics of Colonic Polyposis Study, and PI of the ANGELS study investigating the aetiology of early-onset colorectal cancer. He is CIA of a recently funded Cancer Australia Research Initiative (CARI) grant and a NHMRC Centre of Research Excellence grant both focused on identifying the causes of early-onset colorectal cancer. He was awarded the Dame Kate Campbell Fellowship in 2021 and again in 2026.
Speaker
Dr Shaoke Lei
Research Fellow in Cancer Services and Data Science,
Department of General Practice and Primary Care, the University of Melbourne
Dr Shaoke Lei works within the VCCC Alliance Data Connect Program where his research applies statistical methodology and data science techniques to linked health data, with a focus on early cancer diagnosis. His work centres on understanding and improving the pathways through which cancer is diagnosed in primary care.
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