SDHB keen to begin bowel screening

The southern region is so prepared to implement the national bowel screening programme that it could have started yesterday, programme leader Jason Hill says.

''I've been confident for a couple of years that we were able to do this,'' Dr Hill said,

''The only reason we're waiting is because the new colonoscopy unit is not quite ready, but if we had to go today that wouldn't be an issue.''

The screening programme will begin at the end of April - comfortably ahead of the Ministry of Health deadline of the end of June.

Bowel cancer generally strikes people over 60, with European males most commonly afflicted by the disease.

The Southern DHB region has more elderly and Europeans than most other parts of New Zealand, meaning it has one of the highest rates of bowel cancer in the country.

Early results suggest 7% of people who have a follow-up colonoscopy after a positive test will actually have cancer.

''In the first year, we are expecting an additional 50 to 80 cancers being diagnosed,'' Dr Hill said.

''However, we have a test which diagnoses people with pre-malignant problems, which is different from something like breast screening where with mammography you are diagnosing breast cancer.

''We are diagnosing polyps which can be removed before they even become cancers, so you can see what the benefit might be for that individual in 10 to 15 years' time.''

Dr Hill anticipated 60% of people invited to take part in the screening programme would do so, but with the high level of interest in the disease in the region he had planned for a response rate of up to 80%.

Although most people screened by the programme would not have the disease, for those who did the nature of the test meant an early diagnosis could not only be a life-saver but also a life-changer, Dr Hill said.

''People who get bowel cancer but who may not die will still have to go through a surgery, have chemotherapy, radiotherapy, a significant amount of intervention which impacts on their quality of life over a long period of time before they are back on the road to recovery again.

''Not only do we save lives, but we also save all of that associated cost which goes with a bowel cancer diagnosis.''

The roll-out of the national screening programme has not been without controversy, and an inquiry is now examining issues which arose in the trial programme in Waitemata where some people missed out on their invitation to take part.

''I think all advertising is good advertising to some extent, and if it raises awareness in individuals and the region to make sure their details are up to date with the general practice or the organisation, then that all bodes well for us,'' Dr Hill said.

New staff. including a senior medical officer, nursing and administration staff have almost all been employed, and work is ongoing to cope with the anticipated rise in colonoscopies which will need to be carried out after a positive bowel cancer test.

Complication rates from colonoscopy in the pilot screening scheme were ''exceedingly small'' Dr Hill said, and quality of care for anyone undergoing the procedure would be excellent.

''The colonoscopy should be pretty routine stuff for my team, who do these every day.''

Dr Hill has been liaising closely with doctors across the region, and has had 35 hours of general practice meetings in the past month to ensure all primary health professionals know the programme is about to start.

''We did 19 meetings across the entire district ... everybody in the district who is a GP should know who I am.''

mike.houlahan@odt.co.nz

The facts

What is bowel cancer?

Bowel cancer occurs when cells inside the bowel become abnormal and grow out of control. Classic symptoms are blood in faeces and a change in bowel motions. About 3000 New Zealanders are diagnosed with the disease each year; 1200 die from it.

What is the screening programme?

A nationwide programme aimed at detecting bowel cancer early. Unlike many cancers, it can be detected early and treated successfully.

Who is eligible?
An estimated 51,000 people aged 60-74 will be invited to take part.

What happens?

People are asked to take a small faeces sample and sendit to the programme, along with a consent letter.

What next?

Test results will be mailed out within three weeks. If they are clear, a follow­up test is recommended every two years. If there is an issue, a colonoscopy will usually be carried out.

The results

About 70% of people who have a colonoscopy will have polyps, which, if removed, may prevent cancer developing. About 7% of colonoscopy patients will have bowel cancer.