Changes To Bowel Screening Age At The Expense Of Māori Programme Deeply Disturbing

The Government’s plan to lower the age for free bowel cancer screening to 58 by redirecting money previously set aside to lower the age to 50 for Māori and Pacific people is deeply disturbing, unjust and flies in the face of delivering services according to need.

Under the plan, the age of eligibility for free bowel screening would progressively drop from 60 to 58 for all New Zealanders. In December the government announced the end of a pilot programme that allowed Māori and Pacific people to access bowel cancer screening starting at age 50. While Māori and Pacific people already on the screening programme aged between 50 and 60 will still be able to access the programme, no new patients will be brought in.

Bowel screening saves lives. Early-stage cancers have a much better chance of being treated successfully. Most Māori diagnosed with bowel cancer are under the age of 60, compared to just under a third of non-Māori. “Bowel cancer happens at a younger age in Māori and that is why screening Māori for bowel cancer should start at a younger age” says New Zealand College of Public Health Medicine President Sir Collin Tukuitonga. “It is a no-brainer. This is clinically, scientifically and ethically sound” he says.

Tukuitonga says the government’s plan will clearly favour non-Māori and non-Pacific. “The plan will knowingly increase inequities in bowel cancer incidence, survival and death rates between Māori and non-Māori. There is no other way to describe this than an example of deliberate institutional racism.”

The College has previously published a statement on ethnicity as a marker of need.1 Targeting of health services for specific population groups, including by ethnicity, is scientifically sound and leads to better resource allocation. Ignoring ethnicity risks perpetuating inequities and wasting public resources due to less effective targeting of groups most in need.

If the Government is committed to an evidence-based approach to healthcare that is delivered on the basis of need, then it must increase access to bowel screening at a younger age for Māori and Pacific populations.

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