The Ministry of Health should proceed with existing plans for its bowel cancer screening pilot and at this stage it should not include flexible sigmoidoscopy (FS), the Gastroenterology Society says.
The society's president, Associate Prof Susan Parry, said it would be a shame "having come this far" to delay the introduction of the pilot to plan for a flexible sigmoidoscopy pilot - "New Zealanders deserve more than that".
Flexible sigmoidoscopy internally examines the lower bowel, whereas colonoscopy looks at the whole bowel.
There had not been a population study using FS for screening and it would be " premature" to add it to the four-year Waitemata pilot due to start in October using a faecal occult blood test. That did not preclude it from being considered in the future.
The immunochemical faecal occult blood test (iFOBT) to be used in the pilot was still the test being chosen for other countries still planning programmes.
University of Otago cancer researcher and screening programme authority Associate Prof Brian Cox last week repeated his criticisms of the decision to use iFOBT, saying it was out-moded. The most recent research showed a one-off FS would be more effective and cost-effective, he said.
He considered if training began now, an FS-based screening programme could be established in about 18 months.
Prof Parry said using non-specialist practitioners for FS, such as general practitioners or nurses, had been suggested but it had not been determined this was the "right solution for New Zealand".
Flexible sigmoidoscopy was still a technical procedure with risks and Prof Parry considered the specialists working in the field, including general and colorectal surgeons who performed colonoscopies, along with their nursing colleagues, were the ones who needed to find what would suit New Zealand in conjunction with Health Workforce New Zealand.
It was important the specialists delivering colonoscopies and endoscopy were involved because if a decision to use non specialist endoscopists was made in future, the new endoscopists would need to work within a supportive team environment and would require oversight by a specialist.
The FS procedure was an endoscopy requiring theatre space and technical expertise.
