Bowel Cancer New Zealand welcomes faster, simpler test for patients with symptoms

New pathway will speed up diagnosis, ease waiting lists, and save lives

Bowel Cancer New Zealand (BCNZ) is welcoming a new, fast and convenient way to test for bowel cancer symptoms – a change set to transform care for thousands of people across Aotearoa.

Currently, most people referred by their GP for investigation must undergo a colonoscopy. Under the new approach, patients instead receive a free at-home test – the faecal immunochemical test (FIT) – similar to the national bowel screening test. Results are returned within 14 days and help determine the right care for each patient.

The new pathway was confirmed by the Government as part of Saturday’s announcement on bowel screening expansion. Health Minister Simeon Brown said the FIT for Symptomatic programme is expected to “free up specialist capacity by prioritising colonoscopies for those at highest risk and reducing unnecessary referrals, leading to shorter wait times, faster diagnoses, and more resources to expand screening.”

The FIT for Symptomatic pathway means anyone of any age with bowel symptoms referred for specialist assessment can now quickly check their risk without needing to wait for a colonoscopy.

Three major potential benefits

The new approach is better for patients, for doctors, and for the health system:

• For patients – More timely reassurance for the majority who test negative, reducing weeks of anxiety and avoiding unnecessary colonoscopies. This enables quicker access for everyone who does need the procedure, and ensures fast-track investigation for those identified to be at greatest risk.
• For doctors – A quicker, simpler, highly effective tool to investigate symptoms and help rule out bowel cancer.
• For the health system – Health New Zealand estimates the change has the potential to reduce the number of patients added to colonoscopy waitlists by 30 to 60 percent – a significant increase in capacity that supports both symptomatic patients and the expansion of the screening programme.
• Patients who test negative but whose symptoms persist beyond six weeks will remain supported through a “safety-net” re-referral process.

Informed by evidence and patient voices

The new pathway was first recommended by a national taskforce of clinical leaders in 2022 and approved by New Zealand’s Clinical Governance Group in late 2024. FIT testing for patients with symptoms has been adopted internationally since 2017, with research showing it is highly effective at ruling out bowel cancer in symptomatic patients. Pilots in Waikato and Waitematā during 2022–23 confirmed the test is safe, effective, and equitable.

BCNZ role and rollout

BCNZ has worked closely with Health New Zealand as they developed this important change, providing feedback on plans and clinical protocols with input from patients and expert medical advisors. The charity has also contributed to the design of patient-centred communications to ensure the pathway reflects real experiences.

The new approach is already operating in Waikato and will be introduced in Counties Manukau, Waitematā, and Hawke’s Bay over the next two months, ahead of a nationwide rollout next year.

Together with the recent lowering of the screening age to 58, this change marks an important shift toward faster, fairer, and more accessible bowel cancer detection across Aotearoa.

What experts say

Dr Sue Crengle, general practitioner and medical advisor to Bowel Cancer New Zealand, said:

“As a practising GP I really welcome this change. We hope to see Health NZ complete this rollout as soon as possible so that from early 2026 accessible and equitable diagnosis is available for people in every community across Aotearoa.”

Peter Huskinson, Chief Executive of Bowel Cancer New Zealand, said:

“This change is an encouraging step forward. Faster reassurance, earlier diagnosis, and shorter waiting lists are all important for patients. We are looking to Health New Zealand to roll out these changes to all districts as soon as feasible. As long as funding for frontline services is maintained, this change will help address long waits for colonoscopy and help enable the Government’s 2023 pledge to match Australia’s screening age to finally be delivered.”

Notes:

• FIT stands for faecal immunochemical test – a laboratory test which detects microscopic levels of blood in a tiny sample of a patient’s stool (poo).
• Rollout: Waikato has been operating the new pathway since August 2025, with Waitematā, Counties Manukau, and Hawke’s Bay commencing over the next two months.
• Under the FIT for Symptomatic pathway, patients with bowel symptoms referred by their GP are offered a FIT test to help assess their risk.
• Around 80 in every 100 patients will return a negative FIT result and are considered highly unlikely to have bowel cancer. These patients are discharged back to primary care for ongoing management.
• The test also identifies around 6 in every 100 patients tested as “high positive,” ensuring they can be fast-tracked for urgent colonoscopy. Others with positive findings are listed for colonoscopy within the recommended standard waiting time.
• Some patients may bypass FIT and be referred directly to colonoscopy or specialist clinics depending on their symptoms.
• The FIT pathway is expected to reduce the circa 33,000 non-urgent patients added to colonoscopy waitlists each year by 30–60 percent.
• Almost 63,000 colonoscopies were performed in New Zealand in 2023, including just under 7,000 as part of the National Bowel Screening Programme.
• The new pathway was recommended by Te Whatu Ora’s Planned Care Taskforce of doctors and health leaders in September 2022.

BCNZ emphasises the importance of:

• Safety nets: Ensuring patients with ongoing or worsening symptoms after a negative FIT test are re-referred and monitored, to avoid any missed cancers, in line with international guidelines.
• Equity monitoring: Publishing data on test return rates, pathway completion and outcomes to assure that Māori and Pasifika – who currently face poorer survival rates – are benefiting equally from the change.
• Future improvements: Making tests available directly from GPs, which patients report would be faster and more convenient, as used in other countries. BCNZ’s 2025 GP survey found 68% of respondents said the test would be “very useful,” 15% “fairly useful,” and only 4% said it would not be useful.
• Capacity planning: The Government must continue to maintain investment in colonoscopy capacity and workforce each year to meet demand from population growth and rising early-onset bowel cancer. This will ensure the starting age for screening can be reduced to 45 and earlier screening for Māori and Pasifika reinstated by using the freed-up capacity from the FIT symptomatic pathway change.