Government’s decision to axe bowel screening pilot for Māori and Pacific peoples slammed by health experts

The Māori Cancer Leadership Network is calling out the termination of a Waikato based bowel screening pilot for Māori and Pacific people as shocking.

Hei Āhuru Mōwai, a national organisation that focusses on improving cancer care for Māori, says the poorly informed decision is devastating for whānau.

On December 5, health organisations were notified to immediately end access to the bowel cancer screening age extension pilot for Māori and Pacific peoples turning 50.

In the Waikato region 50+ screening pilot, six people were diagnosed with cancer, and many more had precancerous polyps removed.

Without the pilot, these whānau would not have had access to screening until age 60, meaning their cancers would have grown giving them a smaller chance of survival.

Hei Āhuru Mōwai CEO Gary Thompson is urgently calling for a pause on this decision, saying that it conflicts with current medical evidence and was made without notice, leaving no time to consider its impact or communicate the change to providers and whānau.

“Returning to the 60-yr age limit for Māori and Pacific peoples means that the bowel screening programme will increase inequities in bowel cancer incidence, survival and death rates between Māori and non-Māori.”

The axing of the programme will negatively influence the 7–8-year life expectancy gap between Māori and non-Māori and cause harm to Māori and Pacific peoples.

Dr Rawiri McKree Jansen says most Māori who get bowel cancer are diagnosed before the age of 60 which is when the bowel screening programme starts.

“Bowel screening detects small, potentially curable cancers and prevents cancer by removing precancerous polyps. Both Māori and non-Māori have a similar chance of getting bowel cancer, but over half of Māori who get bowel cancer are diagnosed before the age of 60 years (58% in females and 52% in males). This is compared to just under a third for non-Māori (27% in females and 29% in males),” says McKree Jansen. 

“For non-Māori, three quarters of people are diagnosed over the age of 60. Keeping bowel screening available to Māori and Pacific peoples from age 50 would make the national bowel screening programme fair.”

Additionally, Māori bowel cancer rates are increasing.  In contrast, non-Māori have a downward trend in bowel cancer diagnosis.  

University of Otago modelling shows that the Bowel Screening Programme would increase inequities, offering more than twice the health gain for non-Māori if screening is limited to ages 60-70 for Māori.

However, the programme would be equity-neutral, delivering equal health gains for all groups if Māori and Pacific peoples are screened from age 50 and non-Māori from age 60.

Hei Ahuru Mowai recommends that bowel screening start from age 50 for Māori and Pacific peoples. The expanded programme should be rolled out nationally as soon as possible, with resources invested to improve access for groups with low access to bowel screening.