Physicians are coming down hard on the Government's evidence being used to prop up their changes to bowel cancer funding.
Last week, the Government announced it will scrap a programme lowering the screening age for Māori and Pacific people, decreasing the age to 58 for everyone instead.
Royal Australasian College of Physicians's Dr Matt Wheeler says the claim that bowel cancer risk is similar across all groups at the same age isn't true.
"The actual peak age of diagnosis is earlier in Māori than non-Māori. That was why the original screening programme had bowel screenings down to the age of 50."
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Episode Transcript
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Speaker 1 (00:00):
So we brought you the story last week of the
bow screening program. The government has moved to lower the
age for everybody from sixty down to fifty eight. Now
that has meant that they have cut a program that
was lowering the age from sixty down to fifty for
two particular ethnic groups, for Marty and Pacifica. Now, last
(00:21):
week I asked the Health Minister whether Marty and Pacifica
are more predisposed to getting bowel cancer at a younger age.
This is what he said.
Speaker 2 (00:31):
No, the advice is that bowel cancer risk is similar
across all population groups at the same age, so that
that's the even right that we've presented by the Ministry
of Health.
Speaker 1 (00:42):
So listening to that with some doctors who thought there
was something wrong. Matt Wheeler is with the Royal Australasian
College of Physicians. Matt, Hello, Killy, how are you get calder?
Thanks for being with me? Is that true?
Speaker 3 (00:57):
From what I have seen? And I think the caveat
here is that I'm a hematologist. I'm not an oncologist,
but I'm also a general physician and so do work
quite significantly in diagnosing cancers. But from what I can
see from the experts, and this includes groups from the
University of Otago, Hey Yahood and Malway. That's not true
(01:21):
that the actual peak age of diagnosis of bow cancers
is earlier in Mary than non Marty, and that was
why the original screening program had bow screening down to
the age of fifty for Marty and Pacifica, yet had
the screening age stop its down to sixty for non
Marti populations. Because of the difference in an age of
(01:42):
diagnosis and the proportion of young diagnosises of bow cancer.
Speaker 1 (01:48):
What you're saying is quite significant then, because basically you're
saying the Ministry of Health is wrong when they say
that bow cancer risk is similar. Doesn't matter what color
you are.
Speaker 3 (02:00):
Yeah. One, and and there's there's plenty of publications and
groups that have previously said it. There's even a specific
report that was produced by the Marty Doctors Association called
the Order that specifically said that that percessible bowel cancers
were diagnosed in Marty under the age of sixty. And
(02:24):
there's there's some quite significant graphs out there that show
the peak and incidents is different from it's a non Marty.
Speaker 1 (02:30):
So when the because the Minister says that this will
save an additional one hundred and seventy six lives over
twenty five years. You guys have put out a press
release today saying that this will cause more deaths. So
you can't both be right. So for anyone listening at home,
I mean, this is a bit of a stale mate,
isn't it.
Speaker 3 (02:49):
Well, it's all about how you crunch the numbers. So
if you if you looked at the number of additional
beaks that would prevented over twenty five years for the
lowered age, which is down to fifty, you were actually
getting three hundred and ninety deaths that you would prevent
over twenty five years. That's three hundred and ninety people.
(03:11):
That's three hundred ninety five No, that would lose a
loved one. By changing the age for everyone down to
fifty eight, you prevent five hundred and sixty sixt deaths. Now,
that's simply because the non MLI population, including the mighty population,
by shifting that down to fifty eight, is just sheerly greater.
(03:32):
By talking the whole numbers, but isn't that the point
of a difference.
Speaker 1 (03:36):
A public health system should try and do the greatest
good for the greatest number of people, should it not?
I mean, if you if you've got limited money and
you can save an additional one hundred and seventy six lives,
shouldn't you go with that option? Otherwise you I mean
you're saying you would kill more.
Speaker 3 (03:54):
Well, the answer then is why aren't you doing both?
Because what you're what this isn't what we're not talking
here limited age standardization. So if you're well, but they've
said that there's money, and they've said they've said there's
money time and again, and that when when when the
need is required? And so when this is the difference
(04:15):
between equality and equity, and equality is about trying to
do the most good for the most number of people.
But that doesn't account for the fact that some people
get diagnosed with cancers ten years earlier than others. And
so what we do in health is we quite often
we talk about quality adjusted life years, and that's talking
(04:35):
about if you've got an age standardized rate where you're
diagnosed with things at a younger age, that that actually
for the amount of money that you're you're.
Speaker 1 (04:45):
Getting get that. That's the other point that we're still
debating right now. Isn't it because the Ministry of Health
has said one thing about that particular issue and you've
got you're telling me today another. So we need to
go ask the Ministry of Health what the hell is
going on.
Speaker 3 (04:58):
So one of the thing that we said in our
statement is show us you're working. Where is your where
is your evidence? Because we can cite studies that are
published in the medical literature that back up what I'm
necessary saying. And as I said, from groups from the
University of otarget.
Speaker 1 (05:14):
We'll awesome, so well awesome, that well awesome because we
have to leave it here, but we will. We will
ask the Ministry of Health to tell us exactly how
they figured that out.
Speaker 3 (05:22):
Appreciate And I think that's the question that we're necessarily
asking because if the advice is wrong, where the where
the college of specialties that deal with us that are
here to help as in how is needed?
Speaker 1 (05:35):
All right, Matt, thanks your time, Matt Wheeler, Royal Australasian
College of Physicians. Now we have reached out to the
Ministry of Health. We've asked them to tell us basically,
show us you're working, How did you how did you
come to that conclusion? So we'll keep you updated on
what they have to say.
Speaker 2 (05:50):
For more from Heather Duplessy Allen Drive, listen live to
news talks it'd be from four pm weekdays, or follow
the podcast on iHeartRadio
So we brought you the story last week of the
bow screening program. The government has moved to lower the
age for everybody from sixty down to fifty eight. Now
that has meant that they have cut a program that
was lowering the age from sixty down to fifty for
two particular ethnic groups, for Marty and Pacifica. Now, last
(00:21):
week I asked the Health Minister whether Marty and Pacifica
are more predisposed to getting bowel cancer at a younger age.
This is what he said.
Speaker 2 (00:31):
No, the advice is that bowel cancer risk is similar
across all population groups at the same age, so that
that's the even right that we've presented by the Ministry
of Health.
Speaker 1 (00:42):
So listening to that with some doctors who thought there
was something wrong. Matt Wheeler is with the Royal Australasian
College of Physicians. Matt, Hello, Killy, how are you get calder?
Thanks for being with me? Is that true?
Speaker 3 (00:57):
From what I have seen? And I think the caveat
here is that I'm a hematologist. I'm not an oncologist,
but I'm also a general physician and so do work
quite significantly in diagnosing cancers. But from what I can
see from the experts, and this includes groups from the
University of Otago, Hey Yahood and Malway. That's not true
(01:21):
that the actual peak age of diagnosis of bow cancers
is earlier in Mary than non Marty, and that was
why the original screening program had bow screening down to
the age of fifty for Marty and Pacifica, yet had
the screening age stop its down to sixty for non
Marti populations. Because of the difference in an age of
(01:42):
diagnosis and the proportion of young diagnosises of bow cancer.
Speaker 1 (01:48):
What you're saying is quite significant then, because basically you're
saying the Ministry of Health is wrong when they say
that bow cancer risk is similar. Doesn't matter what color
you are.
Speaker 3 (02:00):
Yeah. One, and and there's there's plenty of publications and
groups that have previously said it. There's even a specific
report that was produced by the Marty Doctors Association called
the Order that specifically said that that percessible bowel cancers
were diagnosed in Marty under the age of sixty. And
(02:24):
there's there's some quite significant graphs out there that show
the peak and incidents is different from it's a non Marty.
Speaker 1 (02:30):
So when the because the Minister says that this will
save an additional one hundred and seventy six lives over
twenty five years. You guys have put out a press
release today saying that this will cause more deaths. So
you can't both be right. So for anyone listening at home,
I mean, this is a bit of a stale mate,
isn't it.
Speaker 3 (02:49):
Well, it's all about how you crunch the numbers. So
if you if you looked at the number of additional
beaks that would prevented over twenty five years for the
lowered age, which is down to fifty, you were actually
getting three hundred and ninety deaths that you would prevent
over twenty five years. That's three hundred and ninety people.
(03:11):
That's three hundred ninety five No, that would lose a
loved one. By changing the age for everyone down to
fifty eight, you prevent five hundred and sixty sixt deaths. Now,
that's simply because the non MLI population, including the mighty population,
by shifting that down to fifty eight, is just sheerly greater.
(03:32):
By talking the whole numbers, but isn't that the point
of a difference.
Speaker 1 (03:36):
A public health system should try and do the greatest
good for the greatest number of people, should it not?
I mean, if you if you've got limited money and
you can save an additional one hundred and seventy six lives,
shouldn't you go with that option? Otherwise you I mean
you're saying you would kill more.
Speaker 3 (03:54):
Well, the answer then is why aren't you doing both?
Because what you're what this isn't what we're not talking
here limited age standardization. So if you're well, but they've
said that there's money, and they've said they've said there's
money time and again, and that when when when the
need is required? And so when this is the difference
(04:15):
between equality and equity, and equality is about trying to
do the most good for the most number of people.
But that doesn't account for the fact that some people
get diagnosed with cancers ten years earlier than others. And
so what we do in health is we quite often
we talk about quality adjusted life years, and that's talking
(04:35):
about if you've got an age standardized rate where you're
diagnosed with things at a younger age, that that actually
for the amount of money that you're you're.
Speaker 1 (04:45):
Getting get that. That's the other point that we're still
debating right now. Isn't it because the Ministry of Health
has said one thing about that particular issue and you've
got you're telling me today another. So we need to
go ask the Ministry of Health what the hell is
going on.
Speaker 3 (04:58):
So one of the thing that we said in our
statement is show us you're working. Where is your where
is your evidence? Because we can cite studies that are
published in the medical literature that back up what I'm
necessary saying. And as I said, from groups from the
University of otarget.
Speaker 1 (05:14):
We'll awesome, so well awesome, that well awesome because we
have to leave it here, but we will. We will
ask the Ministry of Health to tell us exactly how
they figured that out.
Speaker 3 (05:22):
Appreciate And I think that's the question that we're necessarily
asking because if the advice is wrong, where the where
the college of specialties that deal with us that are
here to help as in how is needed?
Speaker 1 (05:35):
All right, Matt, thanks your time, Matt Wheeler, Royal Australasian
College of Physicians. Now we have reached out to the
Ministry of Health. We've asked them to tell us basically,
show us you're working, How did you how did you
come to that conclusion? So we'll keep you updated on
what they have to say.
Speaker 2 (05:50):
For more from Heather Duplessy Allen Drive, listen live to
news talks it'd be from four pm weekdays, or follow
the podcast on iHeartRadio
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