Keld Hunia pictured with his wife Harina Warbrick who died of bowel cancer in 2020. Photo / Supplied
Harina Warbrick could still be alive if the bowel cancer screening age for Māori was lowered to 50 sooner, her widower believes.
The 59-year-old Māori wāhine died in March 2020 after being diagnosed with Stage 4 bowel cancer in 2017. Warbrick lived with her husband, Keld Hunia, and their children in Ōhiwa in the Eastern Bay of Plenty.
Hunia said there was a "high probability" that Warbrick's life could have been saved if she had an earlier diagnosis.
"Early testing probably would have picked it up. And that would have been a whole different story.
"She died before she would have qualified to be tested."
His comments come after the national bowel screening programme was extended in Budget 2022 to cover Māori and Pacific people aged 50 to 74. It is currently for those between 60 and 74.
Associate Health Minister (Māori) Peeni Henare said the extension was expected to result in earlier detection of bowel cancer for around 53 people and avoid up to 44 deaths each year.
The initiative would be launched in selected regions this year before being extended nationally from July next year. The cost of expanding the programme is $36.1 million across the next three years.
Bowel Cancer New Zealand said the current screening programme was "inequitable", with more than half of bowel cancers in Māori presenting before the age of 60. Less than a third of bowel cancers in non-Māori were diagnosed before the age of 60.
Professor Sue Crengle, Bowel Cancer New Zealand's medical advisor, said a "worrying number" of Māori and Pasifika presented with advanced Stage 3 or 4 cancer, significantly lowering their chances of long-term survival.
"Screening will help detect cancers earlier."
Hunia said if the eligibility age was already 50 for Māori it "would have made a difference" for Warbrick because her oncologist said her tumour had been growing for four or five years before it was found.
He said the initiative to lower the eligibility age was "excellent" but getting Māori to take the test could be "troublesome" due to a stigma around getting a colonoscopy and testing faeces.
"Cancer doesn't discriminate ... don't think 'it won't affect me' because you just don't know."
Hunia said Warbrick was fit, healthy and not experiencing any pain when she was diagnosed. She went to the doctor after experiencing diarrhoea symptoms and was eventually referred for a colonoscopy.
"She wouldn't have thought to test early until that symptom."
Hunia said it would have taken six to eight months to get a colonoscopy through the public health system. But Hunia had medical insurance, which paid for a private colonoscopy two weeks after their application in June 2017.
The doctor advised that she had a 4cm long cancerous tumour.
Three weeks later, when she had surgery to remove it, it had grown to 30cm.
Hunia said Warbrick's bowel was removed and she endured three rounds of chemotherapy and radiation in three years.
In May 2018, she had a second surgery to remove another tumour and was told later that year she was in remission.
But in May 2019, the doctors discovered during a third surgery that she had "microscopic cells" of cancer and it was "only a matter of time" before it flared up.
They were told that her cancer was "incurable".
"[We] came home and then had to do the hardest part, which was to tell the children," Hunia said.
"That was the single most horrifying day of the entire three years - just sitting there with the kids telling them that there was no cure and that she was going to fight as much as she could."
She was prescribed a drug to "slow down the process" and allow her to have a better quality of life but she lost her three-year battle with bowel cancer in March 2020.
Hunia said one of his regrets was not going back to Europe with his family while Warbrick was still alive.
When Warbrick was told in 2018 she was in remission, they mentioned to her oncologist they wanted to take their daughters to Europe again. They were told to reconsider as medical insurance would not cover cancer-related costs.
"And I wished he hadn't, because we would've gone.
"If there's something you've always wanted to do, go and do it.
"If you survive, yay. If you don't, you have a memory."
Tauranga woman Rachael Ferguson, 33, was diagnosed with Stage 4 bowel cancer in December 2020. She said lowering the eligibility age was a "step in the right direction".
"But for the likes of us under 50, it's still not helpful."
In light of her experience, Ferguson believed the eligibility age needed to be lowered to 35 and started an online petition.
Ferguson said her petition still stood and she would still "push to lower that age".
Tauranga man Brett Morrison lost his 32-year-old wife Sarah to bowel cancer in May 2015.
Morrison said the change was "a start" and was "getting more promising" as the age was being lowered.
"Obviously I don't think it's quite enough but spending is pretty tight nowadays with everything.
"It's going to make a difference to some families, and that's better than no families."
Morrison said people needed to be their "own advocates" for their health.
"If we know something isn't right we've just got to push and push."
Associate Health Minister (Māori) Peeni Henare said the "younger overall age structure" of Māori and Pacific populations and lower life expectancy meant they had "fewer years of life" to gain from bowel screening under the current age range.
Funding would help close that equity gap, Henare said.
"Budget 2022 invests in resetting our health system ... for Māori, this means reforming our health system so that whānau are able to consistently meet their health needs."
Lowering the bowel screening age was an example of the system changing to "better meet the needs of whānau".
Henare encouraged all eligible New Zealanders to follow the advice of the National Bowel Screening campaign and "make the time to screen".
"This test is easy to do at home and could save your life."
If you have any of the following symptoms, or you are concerned about your bowel health, see your GP right away:
- a change in your normal bowel habit that continues for several weeks
- blood in your poo.
Source: Bay of Plenty District Health Board
Other symptoms:
- A change in bowel habits over a period of time without returning to normal i.e. more or less frequent, incomplete emptying, texture changes.
- Unexplained pain in the abdomen - this may be intermittent and severe.
- Lumps in the abdomen
- Bleeding of any kind from the bottom or noticed when wiping.
Source: Bowel Cancer New Zealand
The 19-year-old disappeared without her wallet or mobile phone.