October 4, 2025 • 9 mins
Experts say better staffing numbers will be key to improving bowel-cancer screening.
The screening age is set to lower to 58 for Northland, Auckland and the South Island today, with the rest of the North Island to follow in March.
More than 120,000 people will qualify for screening in the first year of this change, and the Government aims to boost colonoscopy capacity to lower the age screening age further.
But colorectal surgeon Frank Frizelle says there's plenty of capacity to expand it, but more resources are needed.
"The Government is walking very cautiously in this line, because it's worried that its resources won't be able to deliver. To me, it doesn't seem to match up."
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
You're listening to the Sunday Session podcast with Francesca Rudkin
from News talksb.
Speaker 2 (00:13):
SO tomorrow, our bow cancer screening age drops from sixty
to fifty eight for those in Northland, Auckland and the
South Island to the rest of the country to follow
in March next year. The government has also announced a
new nationwide launch of fit tests, which is an at
home test for those with symptoms to check for traces
of blood. But does any of this go far enough?
We have seen in the news a large increase in
(00:34):
those under fifty being diagnosed with bow cancer and age
group completely missed with a screening age of fifty eight.
So to discuss this, leading colorect or surgeon Frank Frazel
joins me. Now, good morning, Frank, thanks so much for
your time, Thanks very much for talking. So as I said,
the free bow screening age is going to be loud
from sixty to fifty eight. It's a move that the
(00:54):
Health Minister Simeon Brown says is a significant step towards
aligning our screening age with Australia, which seems like a
bizarre thing to say. It is nowhere near Australia's screening ages.
A drop of two years doesn't seem significant and doesn't
really put us close to Australia.
Speaker 3 (01:11):
At all now it doesn't. Know, it is very much
a overstated claim by the minister, but as you realize,
politicians tend to be a bit prone to hypertrophy.
Speaker 2 (01:24):
To probably let people know that in Australia people aged
forty five to forty nine can request their first bowel
cancer screening kit. So quite a difference there. Why can't
we lower the screening age around the country all at once,
Why do we have to do it in bits and pieces.
Speaker 3 (01:39):
Well, according to the minister's previous comments and the Ministry's comments,
it relates to capacity for kolonoscopy. Now, if we look
at this, the Mister said this will increase one hundred
and twenty five people will now be eligible. Now we
know from previous work with the present screening age that
that means roughly half that number might take it up.
(02:02):
The others either not interested or they're already having kolonoscopy. Well,
for whatever reason, they don't want to participate. So that's
roughly sixty odd thousand people now with about a five
percent chance of needing colonoscity. That relates to about three
thousand kronoscopies that need to be done, and given that
a third of people ensured, that really falls on the
(02:26):
government to provide about two thousand colonoscopies. Now New Zealand
does about sixty five thousand colonoscomies in the public sector
a year, so it's not a substantial increase. However, the
people who tend to drive this from the ministry side
are very conservative, very cautious, and very risk averse. So
(02:47):
given the recent funding for about an than ten eleven
thousand klunoscopies the government is put through, there's more than
enough capacity to expand it, but it's all the infrastructure
about getting stuff out. So the government is walking very
cautiously in this line because it's worried that it's about
its courses to be able to deliver to me. It
(03:09):
doesn't seem to match up. We do have enough to
do this. There is twenty thousand people as you're here,
repeatedly waiting for columnoscopy. But when you're doing sixty five
thousand a year, there's always going to be a proportion
of people waiting. And those people were waiting. The problem
lies in smaller, small pockets around the country that haven't
been able to keep up, such as Southland and Northland,
(03:30):
and they're smaller populations and they have an adequttes. They
need some assistance to get their columnists to be waiting list.
But there needs to be a waiting list to a point,
so that could that drives the ability to fill the
lists and to fill the time. Otherwise, if your bus
pulled up and there was no one waiting, it seems pointless.
(03:52):
So there needs to be a number of people waiting.
But twenty thousand probably a bit long, and probably fifteen
thousands about where we need to be, but more the
distribution of that. So we do need more people. We
do need to drive the age down. This is the
first step. It just depends how fast the government actually
lives up to its promise to match Australia.
Speaker 2 (04:16):
Talk me through this fit test. Is this going to happen?
How will it help?
Speaker 3 (04:21):
It probably won't make anywhere near as much difference as
the government's hoping. What it does as a poo test,
which tells that you've got blood in the poo, and
then it gives a number to the amount of blood
that's in the poop, and if you've got a lot
of blood in the poo that you can't see, then
you will be prioritized to have an early chronoscopy. If
(04:42):
you've only got a little bit of blood, then you
will be less of a priority. Now, the issue is
is that some patients will be returned to the GP.
But this is not the same as screening. Screening of
people have no symptoms and you're looking for blood indicates
you should have a chronoscopy. These are people who got
symptoms are ready. So sending someone back to the GP
(05:06):
and saying well, you have no blood that we can
measure it doesn't actually resolve the symptoms. And so I'm
not sure that this is going to be an answer
to the workload issue. There will be some patience will
be just reassured that there's no likelihood of cancer is
low and get on with a GP of bout manager symptoms,
(05:30):
but a lot of people will still need to be
seen assessed. In colomost. We've not just done to rule
out cancer. It has done for lots of other diseases
where we're assessing and managing. And therefore it's a little
bit of a extravagant comment that will reduce colonos to
piece by thirty percent.
Speaker 2 (05:49):
Because I thought the test was really useful for people
who didn't actually have symptoms, but you might just you know,
you might be testing yourself every two years because we
know that bal cancer can come, you know, can be
very quick, and it's like it's like a really good
backup that you can do at home to check that
nothing's changed.
Speaker 3 (06:06):
Yes, without doubt that the identification of some of blood
in you're still in patients with no symptoms is a
very good screening test at the first step. But it's
difficulty is once you've got symptoms, it holds the priority
and it means you've still got If you tune up
to the GP and say you've got a change in
(06:26):
your bowel habit and they fit test is done and
it says, well there's no blood, it still doesn't make
your change in bowel habit go away, and you still
need management for that. And so the issue is the
role of where the colonost be fit into that, where
the GP can manage it, and what happens from there.
Speaker 2 (06:45):
Frank, how do we build our colonoscopy capacity.
Speaker 3 (06:49):
Well, it's a combination of we need staff Basically to
do colonos and as you might remember that in the past,
I've talked about increasing that of gasondrologists, gasindrologists, physicians that
do colos Surgeons do by far and away in a
most smaller populations, such as the areas that are not
(07:14):
that have issues, waiting lists do far and away the
most colonoscopies in those areas, so we need to also
build a surgical capacity for colonoscopy. There has been a
move in small places, in some places to have nurse
connoscopies as well. Wycato has a very well established program
there with a nurse, but it's basically starving and trying
to attract staff to deliver. One of the things the
(07:37):
government's done and quite appropriately, dealing with this waiting list issue,
has been to outsource, which means they don't have to
provide infrastructure. They're only providing for the process, the actual
cost of doing colonosopy. But it's like many things in health,
it's about what you get for your dollar. It's about
how much money you can put into it.
Speaker 2 (07:58):
Frank we're also seeing an increase in boal cancer in
younger people, which makes me think that we really need
to be getting this screening age down fast with little
bit more urgency than what we're seeing. Is it a
concern to you that we're sort of seeing more young people.
Speaker 3 (08:12):
Yes, we're seeing quite a dramatic increase in young people
with bow cancer, and it's increasing quite dramatically over the
whole country. Bow cancer is actually decreasing, largely due to
things like screening and people having colosteds for early symptoms.
But the real concern is this area of young people,
and it's not just that they're increasing, but they're actually
(08:34):
finding it quite hard to get into the system because
the systems set up for older people with bow cancer.
So when someone who's forty turns up with rectal bleeding
or change in our habit, they don't necessarily get engaged.
The public system doesn't necessarily engage with them, and they
often get declined to be reviewed. And that's where the
(08:55):
issue about trying to get young people, trying to get
the symptom awareness and people. But we know a third
of young people under fifty turn up with bow cancer
have incurable disease with one the diagnosed, and that's different
from older people. And because of that symptom awareness and
making people aware that they should do something about it
(09:17):
and get adjusting the system to deal with it. Is
not enough that we really young people will benefit from
much more by having screening age drop down then, more
than any other group.
Speaker 2 (09:29):
Oh look, thank you so much doctor Frank Frazell there
for talking us through these new bow cancer screening ages. Honestly,
we're dropping from sixty to fifty eight. And as I said,
in Australia, people from forty five to forty nine can
request their first bow cancer screening kit. So this is
going somewhere to making us kind of equal to Australia.
We got a long way to go.
Speaker 1 (09:50):
For more from the Sunday session with Francesca Rudkin. Listen
live to news Talks they'd be from nine am Sunday,
or follow the podcast on iHeartRadio.
You're listening to the Sunday Session podcast with Francesca Rudkin
from News talksb.
Speaker 2 (00:13):
SO tomorrow, our bow cancer screening age drops from sixty
to fifty eight for those in Northland, Auckland and the
South Island to the rest of the country to follow
in March next year. The government has also announced a
new nationwide launch of fit tests, which is an at
home test for those with symptoms to check for traces
of blood. But does any of this go far enough?
We have seen in the news a large increase in
(00:34):
those under fifty being diagnosed with bow cancer and age
group completely missed with a screening age of fifty eight.
So to discuss this, leading colorect or surgeon Frank Frazel
joins me. Now, good morning, Frank, thanks so much for
your time, Thanks very much for talking. So as I said,
the free bow screening age is going to be loud
from sixty to fifty eight. It's a move that the
(00:54):
Health Minister Simeon Brown says is a significant step towards
aligning our screening age with Australia, which seems like a
bizarre thing to say. It is nowhere near Australia's screening ages.
A drop of two years doesn't seem significant and doesn't
really put us close to Australia.
Speaker 3 (01:11):
At all now it doesn't. Know, it is very much
a overstated claim by the minister, but as you realize,
politicians tend to be a bit prone to hypertrophy.
Speaker 2 (01:24):
To probably let people know that in Australia people aged
forty five to forty nine can request their first bowel
cancer screening kit. So quite a difference there. Why can't
we lower the screening age around the country all at once,
Why do we have to do it in bits and pieces.
Speaker 3 (01:39):
Well, according to the minister's previous comments and the Ministry's comments,
it relates to capacity for kolonoscopy. Now, if we look
at this, the Mister said this will increase one hundred
and twenty five people will now be eligible. Now we
know from previous work with the present screening age that
that means roughly half that number might take it up.
(02:02):
The others either not interested or they're already having kolonoscopy. Well,
for whatever reason, they don't want to participate. So that's
roughly sixty odd thousand people now with about a five
percent chance of needing colonoscity. That relates to about three
thousand kronoscopies that need to be done, and given that
a third of people ensured, that really falls on the
(02:26):
government to provide about two thousand colonoscopies. Now New Zealand
does about sixty five thousand colonoscomies in the public sector
a year, so it's not a substantial increase. However, the
people who tend to drive this from the ministry side
are very conservative, very cautious, and very risk averse. So
(02:47):
given the recent funding for about an than ten eleven
thousand klunoscopies the government is put through, there's more than
enough capacity to expand it, but it's all the infrastructure
about getting stuff out. So the government is walking very
cautiously in this line because it's worried that it's about
its courses to be able to deliver to me. It
(03:09):
doesn't seem to match up. We do have enough to
do this. There is twenty thousand people as you're here,
repeatedly waiting for columnoscopy. But when you're doing sixty five
thousand a year, there's always going to be a proportion
of people waiting. And those people were waiting. The problem
lies in smaller, small pockets around the country that haven't
been able to keep up, such as Southland and Northland,
(03:30):
and they're smaller populations and they have an adequttes. They
need some assistance to get their columnists to be waiting list.
But there needs to be a waiting list to a point,
so that could that drives the ability to fill the
lists and to fill the time. Otherwise, if your bus
pulled up and there was no one waiting, it seems pointless.
(03:52):
So there needs to be a number of people waiting.
But twenty thousand probably a bit long, and probably fifteen
thousands about where we need to be, but more the
distribution of that. So we do need more people. We
do need to drive the age down. This is the
first step. It just depends how fast the government actually
lives up to its promise to match Australia.
Speaker 2 (04:16):
Talk me through this fit test. Is this going to happen?
How will it help?
Speaker 3 (04:21):
It probably won't make anywhere near as much difference as
the government's hoping. What it does as a poo test,
which tells that you've got blood in the poo, and
then it gives a number to the amount of blood
that's in the poop, and if you've got a lot
of blood in the poo that you can't see, then
you will be prioritized to have an early chronoscopy. If
(04:42):
you've only got a little bit of blood, then you
will be less of a priority. Now, the issue is
is that some patients will be returned to the GP.
But this is not the same as screening. Screening of
people have no symptoms and you're looking for blood indicates
you should have a chronoscopy. These are people who got
symptoms are ready. So sending someone back to the GP
(05:06):
and saying well, you have no blood that we can
measure it doesn't actually resolve the symptoms. And so I'm
not sure that this is going to be an answer
to the workload issue. There will be some patience will
be just reassured that there's no likelihood of cancer is
low and get on with a GP of bout manager symptoms,
(05:30):
but a lot of people will still need to be
seen assessed. In colomost. We've not just done to rule
out cancer. It has done for lots of other diseases
where we're assessing and managing. And therefore it's a little
bit of a extravagant comment that will reduce colonos to
piece by thirty percent.
Speaker 2 (05:49):
Because I thought the test was really useful for people
who didn't actually have symptoms, but you might just you know,
you might be testing yourself every two years because we
know that bal cancer can come, you know, can be
very quick, and it's like it's like a really good
backup that you can do at home to check that
nothing's changed.
Speaker 3 (06:06):
Yes, without doubt that the identification of some of blood
in you're still in patients with no symptoms is a
very good screening test at the first step. But it's
difficulty is once you've got symptoms, it holds the priority
and it means you've still got If you tune up
to the GP and say you've got a change in
(06:26):
your bowel habit and they fit test is done and
it says, well there's no blood, it still doesn't make
your change in bowel habit go away, and you still
need management for that. And so the issue is the
role of where the colonost be fit into that, where
the GP can manage it, and what happens from there.
Speaker 2 (06:45):
Frank, how do we build our colonoscopy capacity.
Speaker 3 (06:49):
Well, it's a combination of we need staff Basically to
do colonos and as you might remember that in the past,
I've talked about increasing that of gasondrologists, gasindrologists, physicians that
do colos Surgeons do by far and away in a
most smaller populations, such as the areas that are not
(07:14):
that have issues, waiting lists do far and away the
most colonoscopies in those areas, so we need to also
build a surgical capacity for colonoscopy. There has been a
move in small places, in some places to have nurse
connoscopies as well. Wycato has a very well established program
there with a nurse, but it's basically starving and trying
to attract staff to deliver. One of the things the
(07:37):
government's done and quite appropriately, dealing with this waiting list issue,
has been to outsource, which means they don't have to
provide infrastructure. They're only providing for the process, the actual
cost of doing colonosopy. But it's like many things in health,
it's about what you get for your dollar. It's about
how much money you can put into it.
Speaker 2 (07:58):
Frank we're also seeing an increase in boal cancer in
younger people, which makes me think that we really need
to be getting this screening age down fast with little
bit more urgency than what we're seeing. Is it a
concern to you that we're sort of seeing more young people.
Speaker 3 (08:12):
Yes, we're seeing quite a dramatic increase in young people
with bow cancer, and it's increasing quite dramatically over the
whole country. Bow cancer is actually decreasing, largely due to
things like screening and people having colosteds for early symptoms.
But the real concern is this area of young people,
and it's not just that they're increasing, but they're actually
(08:34):
finding it quite hard to get into the system because
the systems set up for older people with bow cancer.
So when someone who's forty turns up with rectal bleeding
or change in our habit, they don't necessarily get engaged.
The public system doesn't necessarily engage with them, and they
often get declined to be reviewed. And that's where the
(08:55):
issue about trying to get young people, trying to get
the symptom awareness and people. But we know a third
of young people under fifty turn up with bow cancer
have incurable disease with one the diagnosed, and that's different
from older people. And because of that symptom awareness and
making people aware that they should do something about it
(09:17):
and get adjusting the system to deal with it. Is
not enough that we really young people will benefit from
much more by having screening age drop down then, more
than any other group.
Speaker 2 (09:29):
Oh look, thank you so much doctor Frank Frazell there
for talking us through these new bow cancer screening ages. Honestly,
we're dropping from sixty to fifty eight. And as I said,
in Australia, people from forty five to forty nine can
request their first bow cancer screening kit. So this is
going somewhere to making us kind of equal to Australia.
We got a long way to go.
Speaker 1 (09:50):
For more from the Sunday session with Francesca Rudkin. Listen
live to news Talks they'd be from nine am Sunday,
or follow the podcast on iHeartRadio.
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