Prof Cox, a University of Otago public health specialist and epidemiologist whose research has included bowel cancer control, said the new board could decide to give priority to access to assessment of people with gastrointestinal symptoms, particularly those suggestive of bowel cancer.
The recent Southern Cancer Network audit of 33 referrals to Dunedin Hospital's colonoscopy service showed there was ample scope for the new board to do this with some additional support from the Ministry of Health, he said.
Southland had the highest bowel cancer rates in the world, followed by Otago, he said.
But while Southland rates of publicly funded colonoscopy are the second-highest in the country, which also has a high rate of the disease, Otago has the poorest rate.
The Otago rate at 37.73 per 10,000 people is less than half the national average of 76.89 and well below any other board.
Southland's rate is 119.69.
The West Coast, another area with a high rate of the disease has the highest public colonoscopy rate at 126.36 per 10,000.
Prof Cox said it concerned him that when general practitioners, whose concerns led to the audit, did not have easy access to specialist services they were placed in a difficult position.
Some who might want their patients to get colonoscopies might refer them for tests such as barium enemas because they knew that was available, even though it was less reliable.
Such behaviour meant that doctors were choosing procedures 20 years out of date.
The audit report refers to colonoscopy being the "gold standard diagnostic tool for the early detection of colorectal cancer".
Prof Cox said the extra 200 colonoscopies being offered this year could be seen as a patch and it was important that the fundamental issues with the service highlighted in the audit were addressed.
The number of colonoscopies which ideally should be provided would be much higher than 700.
The audit also showed that the national average number of colonoscopies for each colorectal cancer diagnosed is 10.8.
In Otago, the rate was much lower, showing that for every 5.1 patients who had a colonoscopy, cancer was diagnosed.
Asked whether this low Otago figure could indicate that those most in need of colonoscopies were getting them in Dunedin, Prof Cox said this would be a hard argument to make when the incidence of the disease was so high, the rate varied so much from the national average, and doctors were complaining about delayed diagnosis.
"You might expect the rate to be more like 15."
Prof Cox, who has been involved in the development and monitoring of the breast and cervical screening programmes, hoped the Otago audit would give a push to plans for a national bowel cancer screening programme, rather than being used an excuse to delay it further because of concerns about short staffing.
Training of nurse endoscopists who would work beside gastroenterologists would be a pragmatic way to address staff numbers.
Prof Cox, who was involved in the development and monitoring of the breast and cervical screening programmes, would also like to see any screening programme proceed without a pilot scheme.
He would be particularly opposed to any suggestion of a regional pilot, in the interests of national consistency.
There had been much work done overseas in countries which already had programmes from which New Zealand could learn, including from problems encountered.
"We don't have to recreate everything that's already been done.
It would be a complete waste of time."
He would like to see a national programme, phased in over time.
This could be done by deciding initially to offer the programme to people when they turned 55 or 65 and then extending the programme as resources allowed.
Because the initial test involved could be done by people at home and posted, the programme would be physically much easier to set up than a service such as breast screening, he said.
