Bowel screening 'to save 500 lives a year'

A former Wairarapa surgeon has used the toll from the world's worst aircraft accident as an example of how many New Zealanders could be saved from better bowel cancer screening.
Dr Guy Hingston, now a surgical oncologist working on the North Coast of New South Wales in public and private practice, said preventable deaths would keep occurring until the Ministry of Health brought in an improved screening regime which other countries already have in place.
''Pre-cancerous polyps and early bowel cancers can both be successfully detected and treated at an early stage using a combination of faecal occult blood testing [FOBT] and colonoscopy, often avoiding the major risks of bowel surgery.
''These procedures are successfully preventing thousands of deaths from bowel cancer all around the world today.''
In 2008, the Australian Government's Department of Health and Ageing introduced free bowel cancer screening for all people turning 50, 55 and 65, who are now sent FOBT kits at home.
If the result comes back positive, they are advised to see their own GP, who takes things from there.
The United States Preventive Services Task Force recommends screening for colorectal cancer using FOBT, sigmoidoscopy, or colonoscopy, in adults, from age 50 to 75, and this was based on research published as long as 17 years ago, Mr Hingston said.
''The National Health Service in Britain is currently rolling out a bowel cancer screening programme across the UK.
''For example, Bowel Screening Wales offers bowel screening to men and women every two years. Initially, people aged between 60 and 69 are being invited, and by 2015, the programme will be extended to invite everyone aged between 50 and 74.
''A large trial conducted across Britain has just demonstrated a 43 per cent reduction in deaths from bowel cancer, after performing a single flexible sigmoidoscopy in asymptomatic men and women aged 55 to 64.''
Mr Hingston pointed out the 520 deaths caused by a Boeing 747 crash in 1985 was the same number of deaths that could be prevented in New Zealand through better screening.
''Each year in New Zealand, we accept the same number of people dying from bowel cancer who could have been saved if a single flexible sigmoidoscopy had been performed once in their middle years.''
The Ministry of Health last month announced that it would roll out a FOBT pilot programme, but Mr Hingston believed this was unnecessary.
''We don't need a pilot programme. The only pilot we need is someone with the courage and funding to roll out a national FOBT and flexible sigmoidoscopy programme to save over 500 Kiwi lives each year.
'' What are we waiting for? How long are we going to put up with this completely preventable loss of life?''
But Dr Carol Atmore, clinical director of the new Bowel Cancer Programme, said while current evidence showed that FOBT was the best and most effective bowel-screening test, more information was still needed.
That included finding whether the more invasive flexible sigmoidoscopy would be acceptable to populations as a screening test, whether it would be a ''barrier'' to participation, and what impact it would have on the health workforce, which she said would likely be significant.
''We will continue to monitor international developments and wait to see the outcomes if flexible sigmoidoscopy is adopted in established programmes.''