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October 5, 2025 14 mins

Bowel cancer is New Zealand’s second biggest cancer killer.

Yesterday, the Health Minister confirmed changes to the free bowel screening criteria.

From Monday, the starting age for screenings will be lowered from 60 to 58 in Northland, Auckland, and the South Island. 

The rest of the North Island will follow in March 2026.

Health Minister Simeon Brown speaks to Tim Beveridge. 

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Speaker 1 (00:05):
You're listening to the Weekend collective podcast from News Talks.
I'd be follow tex Central. So.

Speaker 2 (00:12):
Bow cancer is New Zealand's second biggest concer killer. Yesterday,
the Health Minister confirmed changes to the Freeze bow screening criteria.
From Monday, the age for screening will be lowered from
sixty to fifty eight in Northland, Auckland and the South Island.
The rest of the North Island will follow in March
twenty twenty six. It also ended a pilot program that

(00:35):
allowed Marian Pacific people to address bow cancer screening starting
at the age of fifty and Health Minister Simeon Brown
joins me, now, good afternoon.

Speaker 3 (00:44):
Good afternoon, how are you good?

Speaker 2 (00:46):
Thanks? So why fifty eight? How did you pick that age?

Speaker 3 (00:51):
Well, this is the first step to lowering the age
to match Australia and we're going to be doing that
over time and this is the first step in achieving that. Ultimately,
this will mean another one hundred and twenty two New
Zealanders will be offered the free bow screening program. It's
expected to save hundreds of lives over the next twenty

(01:13):
five years. About five hundred and sixty six lives expected
to be saved and prevents seven hundred and seventy one cancers.
And ultimately, whilst we're doing that, we're also working to
increase access to colonoscopies, which is the critical enabler to
be able to allow us to reduce the age further faster.

(01:33):
That is the critical enabler. And so at the same time,
we launched yesterday what's called the FIT for Symptomatic Tests.
It's effectively the same test or the same type of test,
but it's provided to It's going to be able to
be provided to anyone who goes to their GP and
has referred with bowl cancer symptoms to be sent a

(01:55):
FIT test instead of being referred directly for a chlonoscopy.
And that's expected to free up access to chlonoscopies, which
was the key enabler for us to then make further
it day actions in the age.

Speaker 2 (02:06):
So, actually, when it comes to fifty eight, how many discussions,
how much? How do the discussions go, like whether it's
fifty six, fifty seven, fifty nine, is it simply a
question of where you expect capacity to be freed up
in your best estimate on that.

Speaker 3 (02:21):
That's the key enabler to enable us to reduce the
age further is access to klonoscopies, and so that that
is the critical path to being able to reduce the age.
The modeling is that by reducing the age by two years,
that'll be requiring an additional I think another one thousand
cholnoscopies to be done annually ultimately. At the same time,

(02:44):
we are increasing the number of klnoscopies through the diagnostic
Investment program we announced recently, and whilst we're doing that,
we're modeling what's going to be required to achieve a
further reduction in the age. Administer of Health, I want
to see this age reduced as fast as possible. The
Prime Minister has made that very clear that that's what

(03:05):
he wants to see happen, and so this is really
the first step. While is an enormous amount of work
being done so that we can now then make the
next step.

Speaker 2 (03:12):
I guess is that you see fifty eight as being
safely achievable.

Speaker 3 (03:17):
It can be achieved, and it is being achieved. That's
what we're doing right now. But we acknowledge the fact
that beow cancer is our second largest cancer killer. Younger
people are getting it and that's where we need to
move faster, and that's why we're doing the preparation work
now to be able to make a further reduction soon.
But I think it's really important to highlight then you

(03:39):
fit for symptomatic test pathway, which means that your GP
will be able to you know, if you turn up
to your GP with bowl cancer symptoms and are referred,
you will be able to be sent one of these
tests which will be available for anyone of any age.
And I think that's a really big step forward. Not
only does that help assist us with being able to

(04:02):
free up additional colonos could be capacity to reduce the
age further, but actually that opens up that access to
all New Zealanders as that program rolled out.

Speaker 2 (04:11):
How accurate that's a fecal test, I don't know what
if I t question.

Speaker 3 (04:15):
They're both. I mean, if it's a poreo test, that's
what requires a small sample. They're effectively the same test.
The FIT test though is more the threshold at which
it's set effectively is lower, so it's going to be
more more sensitive because and so therefore it's going to

(04:35):
be it's a slightly different sensitivity in which into which
it's it's looking for in the in the fequal matter.
But ultimately the point of that test is to say,
if you turn up to your GP and you have
the symptoms and you're referred, you're able to receive one
of those and if then, if then that comes back positive,

(04:57):
then be referred for a colonist to be Following.

Speaker 2 (05:00):
That, the settings for the FIT test as to what
it picks up in signals you might need a colonoscopy,
what sort of what are the numbers in terms of
picking up people who have or are likely to have cancer.

Speaker 3 (05:12):
So that's where so we've just started. It's been rolled
out so far in the Waikato region and the it's
only just recently been rolled out. The next three districts
are the White and Mata and a Sure counties, Manecau
in Hooks Bay and then the rest of the country
next year. The early advice that early numbers that I've
seen show around twenty percent of people referred are then

(05:36):
referring on for a colonosk be following that, what I.

Speaker 2 (05:39):
Mean is what I'm positively Yeah, So what I mean
is what's the risk of it'll miss someone who should
be tested.

Speaker 3 (05:46):
I think it's very low. It's very low. It's a
very a very These are very good tests. It's an
it's a sort of an internationally sort of adopted type
of methodology. So it was a very good test. And
as I said, the sensitivity is built in to make
sure that what picks up, you know, the vast at
a very high, high, high level. As I said, the

(06:08):
early numbers are I think showing around twenty percent of
people who are in the Waikato where it's so far
being rolled out, have returned positive tests, which then means
they'll then go on to have a coloscopy.

Speaker 2 (06:22):
Why actually tell us about that. That's a strange geographical division,
isn't it for when it's being rolled out? How does
that happen?

Speaker 3 (06:29):
Yeah? So I mean howth New Zealand has been been
pot into four different regions. And so there's North Auckland
and Northland. There is one region. You've got Midlands which
is Waikato and the Taranaki, Gisbon they have plenty of
those areas. You've got the Lower North Island and then
you've got the South Island. So it's four regions. That's
how Health New Zealand manages itself ultimately, and I was visiting.

(06:54):
I was visiting the factory used today where they put
the kits together and they mail them out from there.
They have to obviously resource up to be able to
deliver more tests and send out more of these samples
and more of the on the test kits. So they're
doing two regions start from this Monday, are the other
two start in March. And that allows them to be

(07:15):
able to then gear up and then get that program underway.

Speaker 2 (07:19):
Now there is the issue that critics are saying that
scrapping the plan to lower the screening age for MARI
and Pacifica to fifty is a step backward and could
cost lives. And it seems that, I mean, do you
accept that people within that demographic are more at risk
of bowel cancer and therefore isn't it a problem making

(07:39):
change of that.

Speaker 3 (07:41):
The evidence I've seen is that ultimately the age incidence
is the same across all populations, and so what we
need to do is we need to make sure that
the age is the same and to do and what
we've decided here by lowering it for all New Zealanders,
we're actually able to save the most number of lives.
So that's the evidence that we've seen. In addition to that,

(08:04):
though we have also been we've also provided nineteen million dollars,
which is to targeted investment to help increase the number
of people in those communities where there are lower uptake
off screening. So, for example, Mardi, Pacifica and Asian communities

(08:25):
have a lower uptake of the screening programs, and so
the best thing we can do is to make sure
we lower it for lower the age for all New
Zealanders and then put money towards promoting participation in the
program in those population groups where there is lower participation,
and that will maximize the number of lives that are saved.

Speaker 2 (08:47):
I just needed to get the stats right. Are we
saying that Mari and Pacifica are at no different risk
gauge wise than any other population group.

Speaker 3 (08:55):
Yes, the age related incidents is the same, and so
ultimately what that shows is what we need to be
doing is increasing their participation. That's actually the best thing
we can do is increase the participation in those population groups.

Speaker 2 (09:11):
Are you saying that the participation is the reason that
we have worse statistics in those particular in the Marin
Pacifica populations for instance.

Speaker 3 (09:18):
I think that. What I'm saying is those communities have
lower participation in the programs, and so what we need
to be doing is lowering the age for all New Zealanders,
and we need to be investing in programs which increase
their participation so that we can save the most number
of lives I get bowel cancer.

Speaker 2 (09:35):
That's the biggest challenge, isn't it, Because you can I'm
not talking about Marin Pacifica people. I'm just talking about anyone.
And there'll be people who at risk. You can lead
a horse to water, but you can't make it drink,
so you can make it available, but I mean will
they That's probably the wrong metaphor actually, But that's the
biggest challenge, isn't it. How are you going to make
sure that people who should be taking up this opportunity
for a fit test actually take it up.

Speaker 3 (09:58):
Yeah? And I think that's where part of the Nathan
news stare was not just about the lowering of the age,
but actually investing in a range of thing things to
help assist with those assists with participation, so promoting the
program more, you know, with GPS and primary care organizations.
One of the changes that is be made is to
allow people to have not just the opportunity to put

(10:18):
it in the mail, but actually have place to drop
off their samples at labs near where they live. Now,
for some people put putting that in the mails as
a barrier and so having somewhere you can actually drop
it off helps to reduce some of that stigma.

Speaker 2 (10:34):
Will there be a public awareness campaign and the way
we've seen other sort of.

Speaker 3 (10:38):
And we will, yes, absolutely, and there's going to be
work around how we can increase public awareness as well.
So there's a range of initiatives underway to assist with
promotion promoting the program and I just says Minister of Health,
it's the simple test. It's not hard to do and
encourage all New Zealanders PO eligible to take part in

(10:58):
it and and ultimately gps have a role to play
as well as they're having conversations with their patients to
promote the test ultimately as well, you know where they
as we roll out the fits for symptomatic pathway as well,
and they have those conversations with their patients, they're able
to talk about what the test means as well. So
it's a big positive step forward, but it requires all

(11:20):
parts of the system. To work together to make meaning
zalines aware of what's required.

Speaker 2 (11:25):
Now, I don't want to be overly cynical, but the
cynical quick question is how much of your modeling. So
obviously you work out fifty eight we can we can
manage the amount of testing, and that's you know, people
take it up, but you're going to assume a number
of people won't actually do it. Does your modeling assume
only a certain percentage of people will avail themselves to

(11:47):
what's available.

Speaker 3 (11:49):
Yeah, so we look at we obviously measure how many
people do take up the test, and it's I think
just under sixty percent of people take part in the program.
And so obviously the model looks at a range of factors,
but ultimately the targets we need to improve that number.
At the same time, it is what.

Speaker 2 (12:10):
Are you assuming? So with sixty percent, what are you
assuming the number will be with a good campaign.

Speaker 3 (12:15):
Well, we want to we want to target a minimum
of sixty percent of people are participating, and that's what
we want to tag. We want to target a minimum
of sixty percent of people are participating. And the numbers
I think is slightly under sixty percent of people are
participating at the moment. So you think you have a
minimum of sixty percent participating.

Speaker 2 (12:32):
Could you hand l eighty percent participating?

Speaker 3 (12:35):
Absolutely, we want as many people as possible to participate.
But the point there is we need to do as
much as we can to get as many people to participate,
and that's why we're investing in that increase in the
promotional work.

Speaker 2 (12:50):
So when are we going to be matching other countries
we like to compare ourselves to. For Australia, I mean,
what is Australia. They're going into about forty five, don't they?

Speaker 3 (12:58):
So from forty five to fifty in Australia it is
opt in and then from fifty it is it is
an opt out, similar to what we have. So what
sort of what's that?

Speaker 2 (13:07):
What is that for? Is that for kolonoscopies or fit testing?

Speaker 3 (13:11):
And that is for they are so in their bowls
screening program as we have it in New Zealand, the
age is fifty. In Australia, between forty five and fifty
you can opt into receiving a test being sent out
to you. So that's how that's how the program works.
So what we've made as a commitment to match Australia.
That modeling is underway at the moment. We're putting the

(13:34):
work in to increase the number of colonoscopies that are
being able to be delivered. The modeling will be and
the advice will be coming to us at the end
of this year, so we can then make decisions around
the next steps to lower that age as quickly as
we can.

Speaker 2 (13:47):
Just a quick last one. I mean, what are your
observations in terms of how blas a people can be
about a health risk because you know, often people don't
think about cancer is going to hit them until it
hits them. I mean, so how big a challenge is
it to really get people to take this seriously.

Speaker 3 (14:01):
Look, I think every opportunity we've got to talk to
New Zealand is a out the importance of taking your
health seriously, getting an annual GP check check up. You
might be fit and healthy, but there's nothing wrong with
having a conversation with your GP, taking advantage of these
screening programs which exist. All of these things are simple,

(14:23):
they are easy, there's a lot of a lot of
good evidence behind them. We really just encourage the Zealanders
to take advantage of what's available. It may save your life,
or have that conversation with someone and your family it
may save their life. So it's really important that people
do take part and that's what this is all about,
saving as many lives as possible from cancer.

Speaker 2 (14:44):
Excellent, Thanks so much for your time, Samine really appreciate it.

Speaker 3 (14:48):
Thank you.

Speaker 2 (14:48):
That's Samian Brown, Health Minister.

Speaker 1 (14:51):
For more from the Weekend Collective, listen live to News
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