Bowel screening pilot

The bowel screening pilot is now underway in the Waitemata District Health Board area. The pilot runs for four years from October 2011.

Bowel screening is being offered to everyone aged 50 to 74 living in the Waitemata DHB area who is eligible for publicly funded healthcare.

You can find out more information about the pilot on the dedicated BowelScreening website. Other leaflets about bowel cancer and bowel screening can be downloaded from the Bowel screening pilot resources page.

Other leaflets about bowel cancer and bowel screening can be downloaded in the Bowel screening pilot resources webpage.

What will the screening process be during the pilot?

People eligible to take part in the pilot will automatically be sent an invitation letter, a consent form and a free bowel screening test kit, with detailed instructions on how to use it. The test can be completed at home, and the sample sent to a designated laboratory for testing. Participants will receive their results within three weeks.

What does the test involve?

The bowel screening test is an immunochemical faecal occult blood test (iFOBT), also known as a faecal immunochemical test (FIT). It can detect tiny traces of blood in bowel motions. Blood in bowel motions does not mean someone has cancer, but it can be an early warning sign that something is wrong with their bowel.

To do the test, participants will need to collect a small sample from their bowel motion, using the test kit provided. They can then post the sample to the designated laboratory for testing.

If blood is found in the sample, people will be followed up and offered a diagnostic colonoscopy.

If no blood is detected in the sample, people will be invited back to do another bowel screening test in two years (if they remain in the eligible age range and still live in the Waitemata DHB area).

How accurate is the test?

No screening test is 100 percent accurate. There is a chance that cancer can be missed if there was no bleeding from it when the test was done. That is why screening programmes test people every two years. Bowel cancer may also start to slowly develop in the two years between screening tests. People should always remain watchful for the signs and symptoms of bowel cancer, even if they have had a negative screening test (where no blood was found in their sample).

Why is New Zealand having a bowel screening pilot?

Bowel cancer is one of New Zealand’s most common cancers and the second highest cause of cancer death. Our death rate from bowel cancer is one of the highest in the developed world. In 2009, 2837 people were diagnosed with bowel cancer, and 1244 people died from the disease.

Bowel cancer may occur at any age, although 90 percent of cases are in people aged over 50.

International evidence shows that a bowel screening programme can significantly reduce the incidence of bowel cancer and the number of people who die from the disease, through early diagnosis and interventions.

The pilot will provide essential information that will help determine whether a bowel screening programme should be rolled out nationally.

How was the provider selected to run the pilot?

The Ministry of Health called for proposals from providers interested in implementing and operating the bowel screening pilot. The proposals were evaluated by the Ministry of Health and a wide range of expert advisors. All proposals were evaluated firstly by five technical subgroups, and then by the final evaluation panel.

Why was Waitemata DHB selected?

The panel unanimously agreed that the Waitemata District Health Board (WDHB) proposal best met the selection criteria

The Waitemata DHB proposal demonstrated:

  • an understanding of their current capacity to provide colonoscopies and a clear plan to provide the additional capacity required for the pilot
  • the capacity to treat participants who have a diagnosis of cancer
  • a thorough understanding of the entire screening pathway
  • the ability to utilise their expertise and experience in running their regional breast screening programme
  • evidence of support from primary care providers in the region.

What criteria did the provider need to meet?

The successful provider met stringent criteria including having a sample population of between 60,000 and 130,000 people in the 50 to 74 year age band, including a minimum of 6000 Māori. These numbers are required to ensure the pilot provides enough information to estimate the likely cancer detection rate overall and to inform wider analysis.

The providers were also assessed on:

  • current service provision and their ability to cope with the increased demand created by the screening programme
  • their ability to run a population-based screening programme
  • the level of primary care involvement in developing the proposal and willingness to support the bowel screening pilot
  • their ability to ensure fair access to all eligible people
  • laboratory provision and quality standards
  • colonoscopy provision and quality standards
  • bowel cancer treatment provision and referral to specialists for care.

When will a decision be made on whether to launch a national bowel screening programme?

A decision will be made once the pilot is completed in 2015 and all monitoring and evaluation data has been analysed. This will determine the level of participation, the number of cancers that were detected, the stage of the disease at diagnosis, the impact on health services and the costs involved. Bowel cancer patterns from the pilot area will be compared to areas where there is no screening programme.

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