Lowering the age of eligibility for Māori and Pacific peoples participating in the National Bowel Screening Programme
Waikato and Tairāwhiti have been selected as the first districts to introduce a lower starting age for Māori and Pacific people participating in bowel screening.
Funding of $36 million was announced in Budget 22 to shift the eligible start age from 60 to 50 years for these populations to address a health inequity. The official announcement was made via a press release from the Beehive.
The lower eligible age for Māori and Pacific people will be progressively introduced across the country, following an evaluative implementation in Waikato and Tairāwhiti. More information below.
Q&A on the lowering on the NBSP age range for Māori and Pacific peoples
Why is the age range being lowered to 50 years of age for Māori and Pacific peoples?
This is a step toward addressing an acknowledged health inequity. A higher proportion of bowel cancer occurs in Māori and Pacific peoples before they reach 60 (approximately 21 percent compared to 10 percent for non-Māori non-Pacific peoples). The younger overall age structure of the populations and current lower life expectancy also means fewer health gains from bowel screening under the current age range.
When is the implementation of age extension for Māori and Pacific likely to commence and in which districts?
The evaluative implementation is due to commence in the Waikato and Tairāwhiti districts in the last quarter of 2022, following the transition of all districts to the new bowel screening register (BSR). The evaluation will assess how best to achieve a high participation rate before the lower age range is extended nationally from July 2023. The national target for bowel screening participation is 60 percent.
Why have these districts been chosen?
Selection was based on a number of criteria, including proportion of Māori or Pacific peoples in the districts, colonoscopy capacity and available resourcing.
What happens after the evaluative implementation?
We are looking to test different approaches to engaging and supporting participation by Māori and Pacific peoples, aged 50 to 59, in Waikato and Tairāwhiti. There will be a transition into ongoing service delivery for the two districts and the lessons learnt will inform the wider implementation across the country. We are planning a staggered implementation, beginning in July 2023.
What support will districts get to make the change?
We will work alongside each district in advance to plan when they will join the age range extension and support them during implementation.
Will there be additional funding?
The outcomes from the evaluative implementation will inform what additional supports and resources will be required for successful implementation and ongoing delivery of bowel screening for the younger age group. There will be funding for the increased volumes, ie, for the higher number of colonoscopies and primary care referrals.
What is the impact of the age extension expected to be?
As a result of this extension, 60,000 more people will be able to access screening every year. The initiative aims to increase the number of bowel cancers diagnosed at an earlier stage and in turn reduce the mortality rate and improve outcomes for Māori and Pacific peoples.
Why has this inequity not been addressed earlier?
It was important to complete the national implementation of a clinically safe and effective NBSP to ensure equity of access across the country, before adjustments to the eligible age critirea could be addressed. As soon as the programme was fully rolled out in May 2022 the focus shifted immediately to remedying an acknowledged inequity.