Alarming results in bowel cancer study

An overview of the findings of the Presentation, Investigation, Pathways, Evaluation and Treatment (Piper) project was presented at a public seminar in Auckland today. Photo / Thinkstock

More than 1200 Kiwis die from bowel cancer each year - and New Zealand lags behind other developed countries in the early detection and treatment of the disease, a new report has found.

An overview of the findings of the Presentation, Investigation, Pathways, Evaluation and Treatment (Piper) project was presented at a public seminar in Auckland today.

The three-year project, which focused on the management of bowel cancer, was the largest and most comprehensive colorectal study ever undertaken in New Zealand.

The project involved a national review of patient notes and relevant regional databases for all patients diagnosed with bowel cancer in 2007 and 2008.

Bowel cancer is the most common cancer in the country, and claims the lives of 1200 New Zealanders each year.

The incidence of bowel cancer in New Zealand is one of the highest in the world, and Kiwi patients have a lower survival rate than Australia.

Among its findings, the project found about 30 per cent of bowel cancer patients in New Zealand first learned they had the disease when they presented acutely to hospital, compared with 20 per cent in the United Kingdom.

In addition, only 60 per cent of New Zealand patients with Stage 3 bowel cancer - where the cancer has spread to the lymph nodes - had received chemotherapy. In Australia, a study found 74 per cent of similar patients had received chemotherapy.

Only half of patients with Stage 4 bowel cancer - where the cancer had spread to other organs - had received chemotherapy.

New Zealand also had much higher rates of late presentation of bowel cancer, with 24 per cent of Kiwis diagnosed with Stage 4 cancer from the outset.

The project's principal investigator, University of Auckland oncology Professor Michael Findlay, said the report highlighted that early detection and an increased use of chemotherapy could improve outcomes for patients suffering from bowel cancer.

He said researchers now planned to undertake a detailed comparison with similar projects in Australia and the United Kingdom.

"Given New Zealand's poor colon cancer statistics, we want to know how we perform on several key quality indicators - what we do well, and what we could do better."

Bowel Cancer New Zealand chairwoman Mary Bradley said the research showed the Government was failing New Zealanders by continuing to "stall" on implementing a national screening program.

"People are dying from a preventable, treatable and beatable cancer because they are not being diagnosed early enough. Bowel Cancer New Zealand is calling for an immediate start to a staged rollout which could save hundreds of lives every year."

Health Minister Jonathan Coleman has previously indicated the beginnings of a national programme could be in place from early 2017.

This year, $8 million was given to district health boards as a one-off to do more colonoscopies.

Today, a Ministry of Health spokesman said delivering better cancer services was a top priority for the Government.

"The Piper study is a significant piece of research which will help inform ongoing improvements in the way we approach cancer detection and treatment in New Zealand."

Meanwhile, a pilot screening programme is running in the Waitemata health district for people aged 50 to 74

It began in late 2011 and was to run until December this year, but in its May Budget, the Government granted the Waitemata District Health Board $12.4 million to extend the scheme until December 2017.

The Ministry of Health spokesman said the pilot was providing "valuable insights" which were being used to assess possible options for optimising a future national screening programme to detect and treat the disease.

He said it would be critical that services, such as colonoscopy, were able to cope with the additional volumes which would be created if a national bowel screening programme was implemented.

The scheme was likely to cost between $40 million and $60 million a year.

The project, which began in 2011, was funded by the Health Research Council of New Zealand and the Ministry of Health.

It was supported by all four cancer networks in New Zealand and has included representation from Bowel Cancer New Zealand.

The project also found that a high proportion of Maori and Pacific Island patients were diagnosed with Stage 4 bowel cancer.

Symptoms:

• Bleeding from the bottom or seeing blood in the toilet after a bowel motion
• Change of bowel motions over several weeks without returning to normal
• Persistent or periodic severe pain the abdomen
• A lump or mass in the abdomen
• Tiredness and loss of weight for no particular reason
• Anaemia

Bowel cancer facts:

• Bowel cancer is New Zealand's most common cancer
• Around 1200 people die from bowel cancer each year
• Around 30 per cent of bowel cancer patients in New Zealand learnt they had the disease when they showed up at hospital unwell
• 24 per cent patients are diagnosed with Stage 4 bowel cancer from the outset
• Only 60 per cent of patients with Stage 3 bowel cancer receive chemotherapy
• Only half of Stage 4 bowel cancer patients receive chemotherapy