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Call for NZ to rethink bowel screening

NZ Newswire logoNZ Newswire 3/03/2017

New Zealand needs to rethink its exorbitantly expensive second-rate bowel screening programme based on research from the UK.

That's the view of Associate Professor Brian Cox from the University of Otago who says UK research proves flexible sigmoidoscopy screening is better than the faecal occult blood (FOBT) New Zealand is planning to use.

During a sigmoidoscopy exam, a thin, flexible tube, or sigmoidoscope, is inserted into the rectum, while a FOBT detects very small amounts of blood in a bowel motion before they become visible to the naked eye.

The results of a UK trial of flexible sigmoidoscopy published in The Lancet confirmed the reduced bowel cancer incidence and mortality persists for at least 17 years after the flexible sigmoidoscopy test. The benefit is very likely to persist for the rest of a person's life, Professor Cox says.

He says a 15-minute sigmoidoscopy is by far the most cost-effective strategy for reducing bowel cancer in New Zealand and it could be performed by GPs.

"This is the most cancer-preventing 15 minutes anyone could ever undertake."

A flexible sigmoidoscopy screening test once when aged 55-64 years reduces lifelong risk of bowel cancer by 35 per cent and mortality from bowel cancer by 41 per cent.

Professor Cox says the earlier results of the UK trial at 11 years of follow-up were published in 2010 but were not deemed sufficient by the Ministry of Health to guide the development of bowel screening policy in New Zealand and only a pilot study of two-yearly FOBT screening was pursued.

The evidence from the UK trial clearly indicates the need to completely rethink the approach to bowel screening in New Zealand before an exorbitantly expensive second-rate FOBT programme is instituted, he says.

A national flexible sigmoidoscopy programme could begin within 12 months covering the entire country.

About 3,000 New Zealanders are diagnosed with bowel cancer each year, and it's the second most common cause of cancer death.

Budget 2016 invests $39.3 million for national bowel screening, starting with Hutt Valley and Wairarapa DHBs in 2017.

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