About the National Bowel Screening Programme

The National Bowel Screening Programme is free for people aged 60 to 74 years. It aims to save lives by helping find bowel cancer early when it can often be successfully treated. Free bowel screening is available to approximately 835,000 New Zealanders aged 60 to 74, and to Māori and Pacific people from the age of 50 in some areas. It is offered every two years.

For information about taking part in free bowel screening:

• Visit the bowel screening website
• Phone 0800 924 432
• Email info@bowelscreening.health.nz

Latest programme participation rates are available on the Health NZ website.

This tool allows the participation rate data to be stratified by ethnicity, age, and gender.  

Due to the six-month time frame that participants are given to complete and return the kit, there is a six-month time lag for participation rate numbers.   

New Zealand has one of the highest rates of bowel cancer in the world. Bowel cancer is the second highest cause of cancer death in New Zealand. More than 3300 people are diagnosed with bowel cancer every year and more than 1200 die from it.

Bowel cancer often has no symptoms. The bowel screening test ( a faecal immunochemical test or FIT) can detect tiny traces of blood in the bowel motion. It helps save lives by finding bowel cancer early, when it can often be successfully treated.

A positive bowel screening test result is usually followed by a colonoscopy or further investigation. A positive result does not necessarily mean a person has bowel cancer. Small amounts of blood in the bowel motion are often caused by bowel polyps (growths), or other minor conditions such as haemorrhoids (piles).

Data from our programme shows that the bowel screening test will find at least 7 out of 10 cancers that are present at the time of testing. Bowel cancers do not bleed all the time, so sometimes a cancer can be missed. Bowel cancer may also start to develop between screening tests. For these reasons it’s important to have bowel screening every two years. Participants are advised to see their GP if any bowel cancer symptoms develop between tests. 

About 7 in 10 people who have a colonoscopy as part of the National Bowel Screening Programme will have polyps. These are not cancer, but they may develop into a cancer over a number of years. Most polyps can be easily removed, reducing the risk that bowel cancer will develop.

About 7 in 100 people who have a colonoscopy as part of the programme will be found to have cancer. At least a third of the cancers detected are early stage when they can often be successfully treated.

The National Bowel Screening Programme was rolled out between July 2017 and May 2022, following a successful pilot offering bowel screening to eligible people aged 50 to 74 years living in the Waitematā DHB area. Data collected during the pilot provided vital information on participation levels, cancer detection rates and the impact on health services, and helped inform decisions about the national programme.

Today, the National Bowel Screening Programme sits within Health New Zealand | Te Whatu Ora National Public Health Service.

The operational hub of the programme is Whakarongorau | National Coordination Centre which sends letters to people who return a negative FIT, a spoilt kit or who request a replacement kit. They are also the contact point (freephone and e-mail) for potential participants and GPs who have queries about the programme.

LabPLUS provides laboratory services for the National Bowel Screening Programme.

Health NZ districts carry out screening locally, on behalf of the National Bowel Screening Programme. Districts provide free follow-up investigations such as colonoscopy and other treatments.

The National Bowel Cancer Working Group (NBCWG) is jointly managed by Te Aho o Te Kahu | the Cancer Control Agency and the Health New Zealand | Te Whatu Ora National Bowel Screening Programme. It was initially convened by the Ministry of Health in 2009.

The NBCWG provides advice, expertise and support to Te Aho o Te Kahu and the National Bowel Screening Programme. Members represent a broad range of professional disciplines, including from gastroenterology, endoscopy, oncology, radiology, public health and primary care. There are Māori and equity representatives, consumer representatives, and representatives from the New Zealand Familial Gastrointestinal Cancer Service. The group comprises a total of 16 to 18 members from across the country.

The purpose of the group is to:

• Support Te Aho o Te Kahu and the National Bowel Screening Programme in their efforts to achieve equitable, efficient, and sustainable best practice management of bowel cancer in the New Zealand health system.
• Promote a nationally co-ordinated and consistent approach to the delivery of care for people with bowel cancer or at increased risk of bowel cancer, promoting equitable, timely diagnostic and quality care for all individuals and family/whānau.
• Support Te Aho o Te Kahu to analyse and report on the bowel QPIs, which were initially calculated in 2019 and were recalculated in 2022 (they are next scheduled to be recalculated in 2024).
• Support the National Bowel Screening Programme by providing advice and wider input on clinical or professional matters of relevance to the programme.
• Support the delivery of an effective high quality National Bowel Screening Programme by reviewing and providing advice regarding programme performance data.  

The NBCWG is an advisory group, not a decision-making group. Decision making/accountability sits with Te Aho o Te Kahu and/or the National Bowel Screening Programme for their respective deliverables.

General practice and community care have a key role to play in the success of the National Bowel Screening Programme.

They advise patients of positive test results, refer them for a screening colonoscopy and support them through the process. They also raise awareness about bowel screening and encourage participation.

GPs play an important role in advising their patients if their family history of bowel cancer requires referral for surveillance colonoscopy or referral to the New Zealand Familial GI Cancer Service website.

See also:

• • Do you have a family history of bowel cancer? - Flyer
  • Recommendations for Individuals with a Family/Whānau History of Colorectal Cancer

Making sure all New Zealanders, regardless of their ethnicity or location, have the opportunity to participate and benefit from bowel screening is key for the National Bowel Screening Programme. Currently the programme is not delivering equitable access for Māori and Pacific peoples with participation rates well below the overall programme rate.

The programme promotes equitable participation by:

• targeting actions to increase participation in bowel screening for Māori, Pacific and high deprivation population groups (active follow-up on invitations, targeted health promotion, engagement with community groups, churches and marae)
• supporting Māori and Pacific networks to encourage more participation among Māori and Pacific peoples
• requiring districts to have equity plans, to implement locally appropriate actions
• national monitoring of participation and outcomes by ethnicity
• involving primary care in promoting participation and managing positive results
• multimedia promotions to priority groups
• national governance with a strong focus on equity.

Budget 2022 included funding to lower the eligible start age for bowel screening from 60 to 50 years for Māori and Pacific people.

This is a step toward addressing an acknowledged health inequity. A higher proportion of bowel cancer occurs in Māori and Pacific people before they reach 60 (approximately 21 percent of bowel cancers occur in Māori and Pacific people between the ages of 50 and 60 compared to 10 percent for non-Māori non-Pacific peoples). The younger overall age structure of the populations and current lower life expectancy also means fewer health gains from bowel screening under the current age range.

Three districts have introduced the lower starting age as part of an evaluative implementation: Health New Zealand | Te Whatu Ora Waikato, Tairāwhiti and MidCentral.

Some people may have an increased risk of developing bowel cancer and be advised to have regular colonoscopy or be referred to the New Zealand Familial Gastrointestinal Cancer Service for assessment.

The risk factors include:

• two or more close family members on the same side of the family who have had bowel cancer
• a close family member who was diagnosed with bowel cancer at a young age (under 55 years)
• they or their family have a known or suspected genetic bowel cancer syndrome.

For more on familial gastrointestinal cancer go to the New Zealand Familial GI Cancer Service.

See also:

• Do you have a family history of bowel cancer? - Flyer
• Recommendations for Individuals with a Family/Whānau History of Colorectal Cancer