National Bowel Screening Programme

• 27 March 2023: New-look bowel screening kit rolled out

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 3000 people are diagnosed with bowel cancer every year and more than 1200 die from the disease.

People who are diagnosed with early stage bowel cancer, and who receive treatment early, have a 90 percent chance of long term survival.

Bowel screening every two years can help save lives by finding bowel cancer at an early stage, when it can often be successfully treated. There may be no warning signs that someone has bowel cancer.

Bowel screening can also detect 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.

People eligible to participate in the bowel screening programme are invited to complete a faecal immunochemical test (FIT).The test kit arrives in the mail and is easy to do at home. It can can detect tiny traces of blood in bowel motions (poo) that may be an early sign of pre-cancerous polyps (growths) or bowel cancer.

If a test is positive, participants are invited for additional screening, usually a colonoscopy. A colonoscopy involves looking inside the bowel with a long tube that has a tiny camera on the end. A colonoscopy can identify both cancers and polyps. Polyps are not cancers, but may turn into cancer over a number of years. It is usually possible to remove polyps during the colonoscopy procedure. This prevents them becoming cancer in the future.

For every 100 people having a colonoscopy (an internal examination of the large bowel) after a positive result from their first screening test, six to eight will be found to have cancer and at least a quarter will have advanced polyps that if left untreated, could in time develop into cancer.

More about the FIT test and other aspects of bowel screening can be found on the National Screening Unit website:

• Doing the bowel screening test

The NBSP is based on a successful six-year pilot programme. Information on the pilot is available on the Bowel Screening Pilot page

The programme roll out began in July 2017 with Hutt Valley and Wairarapa the first DHBs to join, and ended with the final DHB, Bay of Plenty, joining in June 2022. The programme is now available across the country.

Since the roll out began in July 2017, the National Bowel Screening Programme has sent out more than a million home test kits and detected cancers in around 1400 New Zealanders. It has also identified and removed thousands of polyps (growths in the bowel) which, if left untreated, can become cancerous over time.

The National Bowel Screening Programme comes under the Ministry of Health’s National Screening Unit (NSU). The NSU oversees and monitors all the Ministry’s national screening programmes.

The operational hub of the NBSP is the National Coordination Centre (NCC), which is run by Homecare Medical, on behalf of the Ministry. The NCC sends out invitations and test kits and coordinates processing and follow-up of test resullts.

The NCC also notifies GPs of results, sends letters to people who return a negative FIT and informs DHBs of positive tests.

The Ministry contracts with Lab Plus to provide laboratory services for the NBSP.

Te Whatu Ora carry out screening locally, on behalf of the NBSP.

Before a region can be approved by the Ministry to start bowel screening, it must show it is able to run a safe and effective bowel screening service. This means having adequate facilities and staffing and making sure it is meeting colonoscopy wait times.

Once they are part of the NBSP, they are responsible for providing free follow-up investigations, and any treatment participants need.

Four regional centres support the regions to develop screening and then oversee clinical standards and other aspects of the programme once it is underway.

GP practices have a key role to play in the success of the NBSP.

They advise their 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 can also refer people with a strong family history of bowel cancer to the New Zealand Familial Gastrointestinal Cancer Service or surveillance colonoscopy – see the brochure for primary health practitioners at Guidance on Surveillance for People at Increased Risk of Colorectal Cancer. (pdf, 884 KB)

Making sure all New Zealanders, regardless of their ethnicity or location, have the opportunity to participate and benefit from bowel screening is important to the programme and the Ministry’s wider health objectives.

The NBSP has established Māori and Pacific networks to encourage more participation among Māori and Pacific peoples.

The NBSP promote equitables 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)
• each DHB having an equity plan, to implement locally appropriate actions
• national monitoring of participation and outcomes by ethnicity, through the bowel screening IT system
• involving primary care in promoting participation and managing positive results
• national governance with a strong focus on equity.

Documents related to the NBSP, such as guidelines and standards, resources and reports, will be published on the NSU website as they become available.

General information on the NBSP and how to do the test is available on Time to Screen.

More information is available, such as:

• information on the NBSP, including frequently asked questions about the programme and key documents relating to the implementation of the programme
• information on the Bowel Screening Pilot, including evaluation reports
• New Zealand guidelines for surveillance for those with a family history of bowel cancer

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