Bowel cancer screening changes ‘dangerous for Māori’, say Māori health leaders

Minister of Health Simeon Brown this month announced he was scrapping plans to lower the free screening age from 60 to 50 for Māori and Pacific peoples. Instead, he would use the funding to extend free screening to all New Zealanders aged 58 to 74.

Costing $36 million over four years, the move would see 122,000 more people eligible for testing in its first year and save “hundreds” of lives over decades, Brown claimed in a release.

‘This decision smacks of political ideology over commonsense health policy and must be reversed.’

But NZNO kaiwhakahaere Kerri Nuku said the move would worsen already-poor health inequities for Māori and Pacific people, a “shockingly high” 21 per cent of whom experienced bowel cancer. This compared to 10 per cent for non-Māori.

The Cancer Society described Brown’s data as “very selective“.

Nuku said it was not only selective but “outright dangerous to the lives of Māori and Pacific people”.

“The Coalition Government claims to put need before race but there is a clear evidential need to screen Māori and Pacific people at an earlier age.”

Bowel Cancer New Zealand has warned the change would mean 100,000 Māori and Pacific people aged 50 would miss out on earlier screening and be at greater risk of later stage bowel cancer when screened eight years later.

“This decision smacks of political ideology over commonsense health policy and must be reversed,” Nuku said.

‘More than half of Māori diagnosed with bowel cancer are under 60, compared to a much smaller proportion of non-Māori.’

Gary Thompson, chief executive of the Māori cancer specialist network, Hei Āhuru Mōwai, said he, too, condemned the Government’s decision not to prioritise Māori and Pacific health. Its chair, Nina Scott, has described it as “institutionalised racism”

Rawiri McKree Jansen, GP and member of Hei Āhuru Mowai, said Māori bowel cancer rates were rising while those of non-Māori declined.

McKree Jansen — formerly Te Aka Whai Ora’s chief medical officer —  said lowering screening eligibility for Māori and Pacific communities would create equitable health outcomes for everyone.

“More than half of Māori diagnosed with bowel cancer are under 60, compared to a much smaller proportion of non-Māori. Māori are also more likely to die within two years of diagnosis.”

In 2022, the Labour-led Government promised to extend the free screening age to 50 for Māori and Pacific communities to reduce health disparities.

“It’s clear the [National-led] Government has abandoned this priority,” McKree Jansen said.

In December, the Government scrapped bowel cancer screening pilots for Māori and Pacific people aged 50-plus in Waikato, Tairāwhiti and Midcentral. Waikato’s two-year pilot finished that month, while Tairāwhiti’s and Midcentral’s are due to finish later this year.

However, Te Whatu Ora says people who have been involved with the pilots would continue to be invited for screening until they are eligible for the national programme (or enter into treatment or further investigation).

Cancer Society NZ director George Laking has also said Brown’s approach would not bring equitable health outcomes for Māori and Pacific communities.

“Because bowel cancer is happening at a younger age for Māori and Pacific, that is the reason why the screening programme should be available at a younger age for Māori and Pacific,” he told TVNZ.

Brown has said the Government plans to progressively lower the age of eligibility for free bowel cancer screening to align with Australia’s, which is 45 — a pre-election promise made by Prime Minister Christopher Luxon. However, he has not been so far able to provide a time-frame on this, saying it depended on capacity at Te Whatu Ora.

He told RNZ that currently Te Whatu Ora could not yet provide enough colonoscopies to lower the screening age beyond 58, but the Government “wanted to go further” and had asked Te Whatu Ora for a plan to rapidly increase colonoscopies.