Opinions sought on screening for cancer

Brian Cox
Brian Cox
The views of 3000 people about two bowel cancer screening tests have been sought in a nationwide survey, part of a 20-month University of Otago study.

The research, funded by the Health Research Council at $666,038, is led by the director of the Hugh Adams Cancer Epidemiology Unit, Prof Brian Cox. It will ask people if they would prefer ongoing screening of faeces samples for blood, or a one-off flexible sigmoidoscopy. The latter internally examines the lower part of the bowel and can involve removal of pre-cancerous polyps.

Prof Cox has been outspoken about plans to use immuno-chemical faecal occult blood tests in the four-year screening pilot due to begin in Waitemata this year, describing the tests as outmoded and not supported by latest research. However, some people might prefer the two-yearly tests to the one-off but invasive nature of flexible sigmoidoscopy, he believed.

The research will also compare the effectiveness and relative value of the programmes and of making a transition to flexible sigmoidoscopy.

Prof Cox said it would be interesting finding out from Britain, where flexible sigmoidoscopy was only just starting to be offered along with a faecal testing programme, what people preferred.

The survey will involve an initial written response, with follow-up telephone interviews.

Prof Cox said he regarded the research as a "vital first step" in terms of assessing the relative merits of the two approaches to screening.

"We do need to get it right if we are going to go on to a national programme".

He expected the results would be available to help inform the Ministry of Health "in a timely manner".

Eight or nine researchers will be involved with the project, including some from the University of North Carolina.

Prof Cox said it was hoped the research would lead to further projects involving the Otago unit and that university.

Ministry of Health cancer programme national clinical director Dr John Childs said news of the research grant was welcomed and the results would be awaited with interest.

The research would add to the information available on the use of flexible sigmoidoscopy as a one-off screening tool and would provide insight into its acceptability to the New Zealand population.

"This information, along with emerging international evidence, will help inform future decisions around bowel screening in New Zealand."

The ministry has consistently advised it considers at this stage using faecal testing for its pilot is in line with international best practice.

The ministry has given no indication of how many years it might be before it is likely to make a recommendation about whether to proceed with a national screening programme.

- elspeth.mclean@odt.co.nz


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