The Cancer Society is calling for Māori and Pacific New Zealanders to get free bowel cancer screening from the age of 50 - a step it says will save lives.
The society's position will put more pressure on the Government to make a change that advocates say is badly needed, because bowel cancer generally strikes those groups earlier in life.
Dr Chris Jackson, the cancer society's medical director and an oncologist, said it strongly endorsed calls for screening to start from an earlier age, particularly for Māori and Pacific.
"We are asking the government to commit to extending bowel cancer screening to those aged 50-59, with priority given to Māori and Pacific people," he told the Herald.
"Māori and Pacific participation in decision-making should be enhanced across all aspects of the programme's planning and implementation."
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Bowel cancer (also called colon, rectal or colorectal) kills more than 1200 New Zealanders every year - more than breast and prostate cancer combined.
Early detection is critical to chances of survival, but the disease can be symptomless and others can be reluctant to act when they appear.
For this reason, health authorities piloted a free screening programme in Waitematā DHB from 2012. West and North Aucklanders aged 50 to 74 years were invited to send in faecal testing kits that detect tiny traces of blood that may signal pre- or bowel cancer. If positive, a colonoscopy is done.
Lives were saved and the previous National-led Government pledged almost $200 million to extend it nationally by June 2021. The roll-out is at the halfway point, with 10 of 20 DHBs offering screening.
However, screening is less likely to help Māori and Pacific New Zealanders. That's because the starting age was moved up a decade when the screening pilot went national, to 60.
More than a quarter of bowel cancers strike Pacific New Zealanders between 50 and 59, the latest annual data shows, with one-in-five Māori bowel cancers taking hold in that time.
That compares to about 11 per cent in non-Maori and non-Pacific.
Modelling has indicated that if the age was lowered to 50, then 60 extra bowel cancers a year could be found in Māori, and 25 extra in Pacific New Zealanders. For context, in 2016 there were 232 bowel cancers in Māori registered, with 81 deaths.
The Ministry of Health says it is "exploring implementation options" to drop the age for Māori and Pacific people, but no decision had been made.
Health workers, academics, and organisations including Bowel Cancer NZ and the Māori Medical Practitioners Association have lobbied for screening to be immediately dropped to age 50 for Māori and Pacific New Zealanders, saying it is unacceptable for a major health initiative to widen inequities.
Peeni Henare, Associate Health Minister with responsibility for Māori health, said it was "crucial to achieve equity of health outcomes for Māori and Pacific peoples", but that for the moment the ministry was focussed on the national rollout.
"It's important to get the foundation right - to establish the programme within available resources first before any changes to parameters are considered that may increase demand, particularly on colonoscopy services," he said in a statement.
Broadcaster and former Silver Fern Jenny-May Clarkson has spoken out in support of dropping the screening age, after her brother died from bowel cancer last year and at the age of 56.
Clarkson is now working with Bowel Cancer NZ to raise awareness of the disease and its symptoms, which can include rectal bleeding, pain, straining and change in bowel habits that last six weeks or longer.