Bowel cancer screening

Aotearoa New Zealand has one of the highest rates of bowel cancer in the world. More than 3000 New Zealanders are diagnosed with bowel cancer each year and more than 1200 die from it.

Bowel cancer occurs when normal cells on the inside of your bowel become abnormal and grow out of control. These cells can turn into a polyp (growth) and some polyps may grow into a cancer over time. There may be no warning signs of bowel cancer in the early stages.

Regular bowel screening of people who do not have any symptoms of bowel cancer provides an opportunity to find bowel cancer early. This means it can be treated sooner and the long-term outcome is likely to be better.

Find out more about bowel cancer symptoms, causes, diagnosis and treatment.

Bowel screening is for people who don’t have any symptoms of bowel cancer. If you have any bowel symptoms that concern you, talk to your doctor straight away.

Bowel Screening Programme - Dr Derek LouNOT (in English)

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(Health New Zealand | Te Whatu Ora, 2018)

This video is also available in Mandarin(external link)(external link) and Cantonese. (external link)(external link)

In the pilot, about 80% of cancers detected were in people aged 60 to 74 years. This means screening is being offered to those most likely to have bowel cancer or have an advanced polyp that can be followed up and confirmed with a colonoscopy.

The age range is being extended to include 50–59 years for Māori and Pacific Peoples because a higher proportion of bowel cancer occurs for Māori and Pacific Peoples before the age of 60 compared to others. The lower starting age for screening will become available across Aotearoa New Zealand over time, but is currently only available in Waikato. When other regions are offering this extended service they will be added to the list on this Time to Screen(external link) page.

So that your medical history (eg, hospital admissions, screening tests) is correctly linked to you, each person is allocated a National Health Index (NHI) number which also includes your age and ethnicity. If your ethnicity is not recorded (or is incorrect) you will need to talk to your healthcare provider to get it updated in order to receive your screening invitation once you become eligible.

• When it's your turn to be screened, you'll receive a letter inviting you to take part. You will also be sent a kit that allows you to collect a faecal (poo) sample at home. It includes a tube that you send by freepost with your poo sample inside.
• The sample will be tested in a laboratory for the presence of tiny amounts of blood that you can’t see when you look at it. If blood is found it may be an early warning sign that something is wrong with your bowel.
• If there are any concerns with your sample, you will be notified and booked in to have a colonoscopy to see if there are any polyps or other signs of bowel cancer.
• A coloscopy is a test to look at the lining of your bowel using a colonoscope – a long, soft flexible tube containing a tiny video camera and a light. It is normally a safe procedure and complications are unusual. If you have any concerns, talk to your healthcare provider.

Tongan - How to do the bowel screening test

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 The “How to do the bowel screening test" is available to view in 11 languages:

• English(external link)
• te reo Māori(external link)
• Samoan(external link)
• Tongan(external link)
• Cook Islands(external link)
• Fijian(external link)
• Kiribati(external link)
• Niuean(external link)
• Rotuma(external link)
• Tuvalu(external link)
• Tokelau(external link)

Resources for clinicians on the national bowel screening programme

Independent assurance review for the National Bowel Screening Programme (1.7 MB, pdf)(external link)(external link) Health Quality & Safety Commission, NZ, 2018
National bowel screening programme for health professionals(external link)(external link) National Screening Unit, NZ, 2017
Quick reference guide for GPs(external link) Health New Zealand | Te Whatu Ora, 2018
National bowel screening programme(external link) TimetoScreen, NZ, 2017
Final Evaluation Report of the Bowel Screening Pilot Screening Rounds One and Two(external link) Ministry of Health, NZ

Guidelines for colorectal/bowel cancer

• Referral of patients with features suggestive of bowel cancer – Ministry of Health guidance(external link)(external link) BPAC, NZ, 2020
• Guidance on surveillance for people at increased risk of colorectal cancer(external link)(external link) NZ Guidelines Group, 2012
• Management of early colorectal cancer(external link)(external link) NZ Guidelines Group, 2011

Continuing professional development

Video: Goodfellow Unit: Internal medicine day - Bowel Screening

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(The Goodfellow Unit, NZ, 2018)