ABOUT BOWEL CANCER

Screening

The National Bowel Screening Programme (NBSP) is being rolled out progressively throughout New Zealand to eligible people
aged 60 – 74.

New Zealand’s National Bowel Screening Programme (NBSP)

When fully implemented, the National Bowel Screening Programme (NBSP) will offer free screening to all eligible New Zealanders aged 60-74. Visit the NBSP website for more information.

The following DHBs now offer free screening: Waitemata, Counties Manukau, Hutt Valley, Wairarapa, Southern, Nelson/Marlborough, Hawkes Bay, Whanganui, Mid Central, and Lakes. The remaining DHBs will progressively join the NBSP with full implementation expected by the end of the 2020/21 financial year.

Once fully implemented, the programme will invite 700,000 New Zealanders to participate in bowel screening every two years. After full roll-out, initial detection rates are estimated at 500-700 cancers each year.

How does the programme work?
Bowel screening will be offered every two years to men and women aged 60-74 who are eligible for publicly funded healthcare.

When it is your turn to be screened, you will receive an invitation letter, a consent form, and a free bowel screening kit. Invitations are sent within two years of the programme starting in your area.

However, bowel screening is not right for everyone. You should not take part if you:

  • have symptoms of bowel cancer
  • have had a colonoscopy within the last five years
  • are on a bowel polyp or bowel cancer surveillance programme
  • have had, or are currently being treated for, bowel cancer
  • have had your large bowel removed
  • have ulcerative colitis or Crohn’s disease that is currently active
  • are seeing your doctor about bowel problems.

If you do not qualify for the National Bowel Screening Programme

Bowelscreen Aotearoa test kits are available for purchase from participating Life or Unichem pharmacies, or online here. Contact 0800 849 104 for more information.

If your pharmacy purchased screening test is positive, the public health system may not pay for your colonoscopy. Please note that the cost of a colonoscopy can range from $1900 to $2500. Private health insurance can cover this cost or the patient pays for this private procedure themselves.

Screening is intended for people who do not have symptoms of bowel cancer. Anyone with symptoms should see their doctor.

Bowel Cancer New Zealand recommends participating in screening appropriate to your personal level of risk*.

Medical guidelines recommend people at average risk of bowel cancer, screen using a faecal immunochemical test (FIT) every 2 years from age 50. If you have one relative diagnosed with bowel cancer at age 55 or older, screening should be considered every 2 years from age 45.

What does bowel screening involve?

A bowel screening test is for people who do not have any obvious symptoms of the disease. However, bowel cancer can develop without any early warning signs and screening is one of the most effective ways to reduce the risk of dying of bowel cancer. When caught early, 75% of bowel cancer cases can be treated successfully.

The screening test is called a Faecal Immunochemical Test (FIT) and it checks for blood in your bowel motion, not for bowel cancer itself. The FIT can detect small amounts of blood in your bowel movement (stool), invisible to the naked eye. Blood can leak from pre-cancerous polyps or early stage bowel cancer and pass into bowel movements before any bowel cancer symptoms become apparent.

A screening kit contains a test stick for collecting a sample of your bowel motion, a sample tube to contain the stick, a consent form for you to sign, and secure packaging for posting the sample to the pathology laboratory for analysis. Results are sent to you and to your GP.

The screening test is simple, clean and fast, and you do it by yourself at home. To learn more, watch this brief ‘how to’ tutorial video and for further information about the National Bowel Screening Programme visit their website or phone 0800 924 432.

Understanding your bowel screening results

A positive screening result
This means blood has been detected in your sample and it is important to see your GP right away to discuss the result and be referred for further investigation via colonoscopy. The presence of blood does not always mean cancer: other conditions such as polyps, haemorrhoids, or inflammation of the bowel can also produce blood in bowel movements. Whatever the cause, bleeding needs to be investigated with a colonoscopy. If polyps are identified they can be removed during this procedure, and a diagnosis of bowel cancer can be confirmed.

False positive test results can occur
False positive results can occur too where screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn’t) can cause anxiety and is usually followed by more tests, such as a biopsy, which have their own risk factors.

A negative screening result
This means blood has not been detected in your sample, and it is recommended that you repeat a bowel screening test every two years. A negative result does not mean that you do not have, or can never develop, bowel cancer because some bowel cancers do not bleed, or bleed on and off. If you develop bowel cancer symptoms in between screenings, see your GP right away.

False negative results can occur
Screening test results may appear normal even though bowel cancer is present. A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if there are symptoms.

*Not all screening tests are helpful and most have risks.

Some people interpret ‘screening’ as ‘prevention’. A screening test cannot prevent a disease however, it can identify abnormalities or irregularities which warrant further investigation, like a colonoscopy procedure to detect (and remove) pre-cancerous polyps or bowel cancer.

 

It may be helpful to discuss screening with your GP or pharmacist before having a test so you are aware of the risks and whether that test has been proven to reduce the likelihood of dying from cancer.