Cancer screening pilot has been a success and will save New Zealanders' lives

The Waitemata pilot is going extremely well, and is a credit to those running it. Photo / Thinkstock

Evidence in support of benefits of strategy 'stronger than for any other cancer'.

An editorial in the Herald states that the value of the screening pilot needs proving and that the pilot "is not going as well as expected".

The editor also moots that if people are alert to their bodily functions we probably do not need a screening programme, and that all bowel cancer presents with ample warning.

We strongly disagree.

The evidence in support of the benefits of bowel cancer screening are stronger than for any other cancer. Five randomised trials of faecal occult blood testing and colonoscopy (the method piloted in Waitemata) consistently show that this mode of bowel cancer screening reduces death rates from bowel cancer. Bowel cancer screening has been or is being adopted in most similar countries worldwide.

The Waitemata pilot is going extremely well, and is a credit to those running it. The uptake rate in the pilot is well within the range expected at the beginning, and at a level that would be expected to reduce deaths from bowel cancer in the population. Rising participation rates will improve the value of screening, and is always a goal of any screening programme. Importantly, the pilot is detecting cancers at a much earlier stage than is seen in the population with symptoms.

Forty-seven per cent of the cancers detected in the screening pilot have been stage one, which has a 90 per cent five-year survival rate. In the current population this number is only 12 per cent. As stage increases, the chance of cure decreases. The pilot has been a success.

Screening programmes do not prevent every cancer. However, it is clear that screening reduces the death rates from colorectal cancer.

It is wrong to say that if people are alert to their symptoms then we don't need a screening programme - these are separate issues. Screening aims to detect people BEFORE they get symptoms, when the cancers are at their earliest possible stage. People with bowel symptoms might have cancer, or they might have another bowel problem. That is why they need different investigations and tests. Both deserve attention.

We do not have a screening programme nationally because there has not been a government decision to have one. Once a decision has been made and funds allocated, then the work on developing the workforce and rolling out the programme nationally can begin in earnest.

New Zealand has one of the world's highest death rates from colorectal cancer. We can reduce this by means of screening AND by early detection of symptomatic cancers, as well as a range of other dietary and lifestyle measures.

The Waitemata pilot has been a success. Patients with symptoms need investigating whether or not we have screening. It is the job of politicians to prioritise funding allocation. It is ours to say whether a proposed intervention for colorectal cancer is effective. We say, loud and clear, colorectal cancer screening saves lives.

Speaking up for screening

• Dr Christopher Jackson, medical director, Cancer Society of New Zealand

• Professor Michael Findlay, Cancer Trials New Zealand, University of Auckland

• Professor Ian Bissett, colorectal surgeon and chair of the National Bowel Cancer Working Group

• Associate Professor Diana Sarfati, director, Cancer Control and Screening Research Group, University of Otago, Wellington

• Mrs Melissa Firth, Piper project manager, Cancer Trials New Zealand, University of Auckland

• Dr Russell Walmsley, president of the New Zealand Society of Gastroenterology
will save New Zealanders' lives.