KEY POINTS:
The Government's aim to introduce a national bowel cancer screening programme by 2011 gives too little time to set it up properly, an adviser to the Health Ministry says.
Caroline Shaw, an author of a report in March on the next steps towards a feasibility study for the
programme, yesterday expressed her concern about this target.
It was difficult to see how it could be done, as it had taken nine years in Australia and Britain, said Dr Shaw, of Otago University at Wellington.
But Associate Health Minister Damien O'Connor is confident the programme can be implemented from the end of 2011.
New Zealand has one of the world's highest bowel cancer death and incidence rates. In 2004 there were 2735 new cases reported and 1173 deaths.
The report by Dr Shaw and colleagues, commissioned by the ministry, says it will take up to seven years to properly prepare for a national programme.
That time includes at least two years to plan a feasibility study and four years to run it, after which the findings must be evaluated.
The study could be a pilot study or the first stage of a national programme.
"Despite being in a good position to learn from other countries, New Zealand would still need to do a huge amount of work to gear up for any sort of colorectal screening activity," the report says.
It says doing the proposed four years of screening would provide valuable design information for a national programme, including which version of screening test or tests to use and the effect on existing health services.
"This information is not able to be reliably extrapolated from other jurisdictions."
But Mr O'Connor said the experiences of breast screening [which took 12 years to start] and overseas bowel screening programmes would help reduce the planning time.
"The ministry will be allocating additional resource to the project to enable effective programme planning over a shorter period."
Quality and safety were top priorities, he said. Implementation would be staged and only those health boards with the capability and facilities would start from day one.
Cancer Society medical director Professor Chris Atkinson said 2011, while "pretty tight", was probably feasible, "if lots of things get put in place pretty soon", but little had been done to expand the colonoscopy workforce, a key pressure point.
THE PROGRAMME
* The Government has been advised to consider a bowel screening programme that would:
* Offer screening to people aged 55 to 74 every two years.
* Be based on tiny faecal samples taken by people at home and couriered in specialised containers.
* Lead to colonoscopy investigation of the bowel for those with a positive result from the faecal screening test and treatment of cancers.
Risks and benefits:
* International trials of bowel cancer screening have shown it can reduce the death rate from the disease by 16 per cent, considered a "modest" reduction.
* But the faecal tests are imperfect, leading to some cancers being missed, and other patients undergoing unnecessary colonoscopies.
