University of Otago research into attitudes towards bowel cancer screening suggests there may be strong support for a screening programme, but says a comprehensive education campaign is needed.
The four-year screening pilot, in which participants will take faecal samples with special kits at home and post them to the laboratory, is due to begin in the Waitemata area in October.
Until now, little has been known about New Zealanders' attitudes to such testing for hidden blood in faeces, but it has been assumed to be one of the biggest challenges for such a screening programme.
The research reported in a New Zealand Medical Journal paper by Dr Tony Reeder today covers interviews with 50 European New Zealanders and is part of a wider study which also looked at the attitudes of Maori, general practitioners and specialists.
The participants in the study, aged between 50 and 71, self-selected by responding to information in city general practices in Auckland, Wellington and Christchurch.
Dr Reeder, director of the Cancer Society of New Zealand Social and Behavioural Research Unit, said there was no suggestion this was a representative study, but the interviews canvassed "pretty much all" the likely views.
On the positive side, a majority of participants identified that the faecal occult blood test (FOBT) was painless, simple, relatively low-cost and could be done at home and in private.
There was concern about the awkwardness of specimen collection and a perception that there would be more reticence about participation among men and the elderly.
Dr Reeder tried using FOBT kits himself to see how difficult they were to use, and he found it was not much of a "hassle".
Negative views about male participation were not universal among study participants.
Some in the study were concerned about the test's accuracy, but others considered regular testing, as proposed, would overcome that in the long run.
There was also concern expressed about the ability of the health system to cope with the extra colonoscopies that would be required under a screening programme.
Dr Reeder said he hoped those planning the pilot would take note of the study findings.
He considers a well-trialled, high-profile public education campaign before the programme was introduced would be critical for achieving acceptable screening participation, particularly among men.
In the journal, an editorial from Beat Bowel Cancer Aotearoa chairwoman Dr Sarah Derrett, also a University of Otago health researcher, echoes his call for a comprehensive public awareness campaign to increase knowledge of the disease.
It was worrying that Dr Reeder's research supported earlier research showing people had difficulty with colorectal cancer symptom recognition, even though colorectal cancer was the country's most common cancer affecting both men and women, she said.
It was also the second leading cause of cancer death.
Dr Derrett expressed concern at the possibility it could be at least eight years before a national screening programme was implemented, if the Minister of Health decided to proceed.
She estimated 10,000 New Zealanders were likely to die from the disease while "we wait for a decision".
Bowel cancer symptoms:
• Change of bowel habit lasting for a few weeks.
• Rectal bleeding persisting with no reason.
• Unexplained anaemia found by your GP.
• A lump or mass in your abdomen felt by you or your GP.
• Persistent severe abdominal pain.
• These symptoms could indicate other conditions, so testing would be needed. Source: Beat Bowel Cancer Aotearoa pamphlet
