National Bowel Screening Programme

The free National Bowel Screening Programme (NBSP) is for men and women aged 60 to 74. It saves lives by detecting bowel cancer early, when it can often be successfully treated. This benefits patients and their families and reduces treatment costs.

Bowel cancer, also called colon, rectal or colorectal cancer, is the second highest cause of cancer death in New Zealand. Around 3000 New Zealanders are diagnosed with bowel cancer every year and more than 1200 die from it.

There may be no warning signs that bowel cancer is developing.

How testing works

People eligible to participate in the bowel screening programme are invited to complete a faecal immunochemical test (FIT).The test kit arrives in the mail and is easy to do at home. It can can detect tiny traces of blood in bowel motions (poo) that may be an early sign of pre-cancerous polyps (growths) or bowel cancer.

If a test is positive, participants are invited for additional screening, usually a colonoscopy. A colonoscopy involves looking inside the bowel with a long tube that has a tiny camera on the end. A colonoscopy can identify both cancers and polyps. Polyps are not cancers, but may turn into cancer over a number of years. It is usually possible to remove polyps during the colonoscopy procedure. This prevents them becoming cancer in the future.

For every 1000 people who complete a bowel screening test, about 50 will be positive. Of those, about 35 will be found to have polyps and on average 3 or 4 will have bowel cancer

More about the FIT test and other aspects of bowel screening can be found  on the National Screening Unit website:

National roll-out

The NBSP is based on a successful six-year pilot programme. Information on the pilot is available on the Bowel Screening Pilot page

The National Bowel Screening Programme (NBSP) is being rolled out gradually across the country. This approach is so District Health Boards (DHBs) have time to prepare for the extra investigations and treatments that flow from a screening programme. It also ensures that people with symptoms are not held up for diagnosis and/or treatment because of the extra demands from screening.

Almost $78 million has been allocated to get the programme running and to cover the cost of establishing a National Coordination Centre and four regional centres. The centres started operating late in 2017. Additional funding has also been set aside for an IT system to support the national programme. The roll-out of the NBSP is expected to be completed by June 2021.

Seven DHBs currently offer screening. They are:

  • Waitemata DHB
  • Hutt Valley DHB
  • Wairarapa DHB
  • Counties Manukau DHB
  • Southern DHB
  • Nelson Marlborough DHB
  • Hawke’s Bay DHB.

Lakes DHB is expected to start screening in February 2019.

When it is available in all areas, the programme will invite about 700,000 people for screening every two years. It is expected to detect around 500 to 700 cancers a year, in the early stages of the roll-out.

Structure

The National Bowel Screening Programme comes under the Ministry of Health’s National Screening Unit (NSU). The NSU oversees and monitors all the Ministry’s national screening programmes.

The operational hub of the NBSP is the National Coordination Centre (NCC), which is run by Homecare Medical, on behalf of the Ministry. The NCC sends out invitations and test kits and coordinates processing and follow-up of test resullts.

The NCC also notifies GPs of results, sends letters to people who return a negative FIT and informs DHBs of positive tests.

The Ministry contracts with Lab Plus to provide laboratory services for the NBSP.

Role of DHBs

DHBs carry out screening locally, on behalf of the NBSP.

Before a DHB can be approved by the Ministry to start bowel screening, it must show it is able to run a safe and effective bowel screening service. This means having adequate facilities and staffing and making sure it is meeting colonoscopy wait times.

Once they are part of the NBSP, DHBs are responsible for providing free follow-up investigations, and any treatment participants need.

Four regional centres support the DHBs to develop screening and then oversee clinical standards and other aspects of the programme once it is underway.

Role of primary care (GPs)

GP practices have a key role to play in the success of the NBSP.

They advise their patients of positive test results, refer them for a screening colonoscopy and support them through the process. They also raise awareness about bowel screening and encourage participation.

GPs can also refer people with a strong family history of bowel cancer to the New Zealand Familial Gastrointestinal Cancer Service [Link] or surveillance colonoscopy – see the brochure for primary health practitioners at Guidance on Surveillance for People at Increased Risk of Colorectal Cancer [link].

Equity

Making sure all New Zealanders, regardless of their ethnicity or location, have the opportunity to participate and benefit from bowel screening is important to the programme and the Ministry’s wider health objectives.

The NBSP has established Māori and Pacific networks to encourage more participation among Māori and Pacific peoples.

The NBSP promote equitables participation by:

  • targeting actions to increase participation in bowel screening for Māori, Pacific and high deprivation population groups (active follow-up on invitations, targeted health promotion, engagement with community groups, churches and marae)
  • each DHB having an equity plan, to implement locally appropriate actions
  • national monitoring of participation and outcomes by ethnicity, through the bowel screening IT system
  • involving primary care in promoting participation and managing positive results
  • national governance with a strong focus on equity.

Find out more

Find out more about the National Bowel Screening Programme, including who is eligible, how to do the test, and when it will be offered in your DHB area.

The National Screening Unit's website has more inforamtion the Ministry’s other screening programmes and for screening information for health professionals.

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