The Ministry of Health has reviewed options for bowel cancer screening for a number of years and screening activity has been increasing internationally in the last decade.

Italy, France, the UK, Australia, Canada and Finland are implementing, or have already implemented, bowel cancer screening programmes.

In May 2008 the Minister of Health announced that a New Zealand bowel cancer screening programme would be established.

The programme is currently in the early stages of development.

Information on New Zealand’s bowel cancer screening programme is outlined below:

Why have a bowel cancer screening programme?
What is involved in the screening process?
Who is the screening programme for?
When will bowel cancer screening be available?
How do I find out more about colorectal (bowel) cancer screening?
Who can I contact if I have any questions about the programme?

Why have a bowel cancer screening programme?
Bowel cancer is the most common cancer in New Zealand and we have one of the highest death rates from bowel cancer in the developed world.

There are approximately 1200 deaths each year and about 2700 new cases of bowel cancer each year. It may occur at any age, although 90 percent of cases are in individuals over the age of 50.

International evidence shows that a bowel cancer screening programme can reduce the death rate by 10 to 15%.

There are clear inequalities in bowel cancer between Māori and non-Māori. Evidence shows that Māori are less likely to be diagnosed, and more likely to die from bowel cancer. This indicates inequitable access to existing cancer services. It is important that the design and development of the bowel cancer screening programme improves outcomes for Māori.

Screening is important because bowel cancer can develop without any early warning symptoms. Bowel cancer can be treated successfully if detected in its early stages.

Bowel cancer screening can also detect polyps. These are not cancers, but may develop into cancers over time. They can easily be removed, reducing the risk of bowel cancer developing.

What is involved in the screening process?
The initial screening test used in overseas programmes is a faecal occult blood test (FOBT). This is a test for blood in the bowel motions where a small sample of bowel motion is collected and tested for the presence of blood.

A person with a negative FOBT will be recalled later for a repeat test. Overseas, the time between screening tests is usually two years.

A person with a positive FOBT result is followed up with a diagnostic colonoscopy. This is where the doctor inspects the entire length of your large bowel by gently inserting a long, flexible tube called a colonoscope into your rectum and then into your colon. A sedative is given before the colonoscopy. The doctor may take a biopsy in the form of a small sample of tissue, which is examined under a microscope or remove polyps. Other means of diagnostic testing also exist.

Who is the screening programme for?
The bowel cancer screening programme is for both men and woman. It is the first time that men will be part of a national screening programme. Overseas programmes usually screen people between the ages of 50 and 74 years, although there is significant variability between different countries.

When will bowel cancer screening be available?
Based on overseas experience it can take over four years to develop and roll out a national bowel screening programme. At this stage the bowel cancer screening programme is in early stages of planning. It will be possible to give a clear timeframe of when screening will be available when the initial planning stages are completed.

How do I find out more about colorectal (bowel) cancer screening?
This report reviews the current international status in relation to CRC screening, examines feasibility/pilot studies that have been conducted, looks at the information a feasibility study would provide New Zealand, provides an outline study design, and outlines the work that needs to be done prior to a feasibility study including an indicative timeline.

Disclaimer: This report was prepared under contract to the New Zealand Ministry of Health. The copyright in this report is owned by the Crown and administered by the Ministry. The views of the author do not necessarily represent the views or policy of the New Zealand Ministry of Health. The Ministry makes no warranty, express or implied, nor assumes any liability or responsibility for use of or reliance on the contents of this report.

Who can I contact if I have any questions about the programme?

Email: bowelcancerteam@moh.govt.nz

Post:  Bowel Cancer Team
          Sector Capability & Innovation Directorate
          Ministry of Health
          P.O Box 5013 
          WELLINGTON