New Zealand health authorities are no nearer to agreeing a
national bowel cancer screening programme.
When asked about a possible decision date, Ministry of Health
national clinical director of cancer programmes Dr John
Childs said "I honestly don't know the answer to that".
• Bowel cancer test level
set
He said he could not commit to a definite time as the
four-year pilot, due to begin in the Waitemata in October,
had to answer some important questions.
Beat Bowel Cancer Aotearoa chairwoman Dr Sarah Derrett said
the organisation would like to see a decision made about a
national programme after the first round of screening in the
pilot in 2014.
If the decision was not made until 2016 or later it could be
another three or four years after that before a programme was
introduced.
The ministry is finalising contract negotiations with those
who will provide the kits for the pilot and Dr Childs said
the outcome would be known within the next month.
Dr Childs again ruled out adapting the pilot, which will use
immuno chemical faecal occult blood testing (iFOBT) to
include flexible sigmoidoscopy (FS), a procedure which
internally examines part of the large bowel.
However, the ministry was waiting for more results from
randomised studies and observing what was happening in
Britain where FS is being added to the existing faecal occult
blood testing regime.
Dr Childs said while there needed to be significant increases
in colonoscopy capacity, such testing had to be done to a
consistent high quality.
"We know we will need more work force. What we don't know is
what level of increase."
A careful planned approach was needed and the ministry had
two clinical leaders working on it.
Questioned why advice about setting up the pilot had been
sought from British bowel cancer screening director Prof
Stephen Halloran, rather than someone such as University of
Otago health researcher Associate Prof Brian Cox, who has
experience of developing and monitoring two New Zealand
cancer screening programmes, Dr Childs said Prof Cox had
"certainly not been shut out".
The Otago Daily Times suggested it could appear his
involvement might not have been sought because his views were
contrary to those of the ministry.
Dr Childs said he had met Prof Cox, who had raised some "key
and significant issues" about bowel cancer screening to which
"very close attention" was paid.
Dr Childs said while Prof Cox had not been "engaged directly
in this programme" he had provided much material which had
been taken into account.
elspeth.mclean@odt.co.nz
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