- Free bowel cancer screening has been expanded from ages 60- 74 to 58-74
- The announcement repurposes funding set aside by the previous government to lower the eligibility age for Māori and Pacific Peoples from 60 to 50
- Every year, more than 3300 people are diagnosed with bowel cancer in New Zealand, and more than 1200 die from the disease
- Australia's current age of eligibility for bowel cancer screening tests is 45
The government has announced plans to lower the age for free bowel cancer screening for all New Zealanders by "redirecting" money previously set aside to lower the age for Māori and Pacific people.
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.
Health Minister Simeon Brown said the age of eligibility for free bowel screening would progressively drop from 60 to 58 at a cost of $36m over four years.
"Lowering the age of eligibility from 60 to 58 will see 122,000 Kiwis eligible for free tests in the first year and save hundreds of lives over the coming decades.
"This is the first significant step we are taking to align our screening rate for bowel cancer with Australia as funding and access to additional colonoscopy resource becomes available."
Photo: RNZ / Nick Monro
It will be lowered to 58 in two of the four Health NZ regions from October, with the other two regions brought on board from March 2026.
Brown said those Māori and Pacific people already on the free screening programme who were aged between 50 and 60 would still be able to access the programme, but no new patients would be brought in.
"Those who started that programme at 50 will still be able to continue through, but what we're saying here is the evidence from the Ministry of Health is very clear that by lowering it to the age of 58 for all New Zealanders, we're actually able to save I think it's 178 addition lives over the next 25 years."
He said the govenrment had also brought in additional testing for Māori and Pacific communities.
"What you see in the evidence is there's actually a lower rate of testing in those communities who are eligible, and so by being able to change the way we approach those communities - provide places where they can drop off their tests, promotional campaigns ... we're able to actually increase that capacity."
Brown said the announcement "repurposed" funding set aside by the previous government to lower the eligibility age from 60 to 50-years-old for Māori and Pacific peoples.
"The changes announced today are projected to prevent an additional 771 bowel cancers and an additional 566 bowel cancer deaths over the next 25 years.
"Advice from the Ministry of Health clearly states that lowering the age to 58 for all New Zealanders will save even more lives than the previous government's approach to lower the age to 50 for Māori and Pacific Peoples only.
"Under our approach, we will be able to prevent 218 additional cancers and 176 additional deaths over 25 years in comparison to the settings proposed by the previous government.
"This also aligns with the government's policy of ensuring that healthcare is delivered on the basis of need."
The Māori Cancer Leadership Network, Hei Āhuru Mōwai's chairperson Dr Nina Scott said increasing the age for Māori and Pacific people was institutionalised racism.
She said it was a deliberate move from the government that would increase inequities.
"The government knows that this initiative that has just been announced will increase inequities in access to screening and in bowel cancer death rates.
"So we're calling this a really good example of institutionalised racism - quite often institutionalised racism is done by accident, this is purposeful, deliberate, knowing act of institutionalised racism.
"We know that extending bowel screening to the age of 50 for Māori and Pacific peoples is cost effective, we can do it today, we have the colonoscopy capacity, it wouldn't create much demand on the system, so we're bewildered quite frankly."
Another member of the group, oncologist Dr George Laking, said the minister had made a "very selective appeal to the evidence" on bowel screening.
"The issue is that proportionally the way they're doing it is going to save more lives within non-Māori community, and non-Pacific community, than within Māori and Pacific community.
"Because bowel cancer is happening at a younger age for Māori and Pacific, that is the reason why the screening programme should be accessible at a younger age for Māori and Pacific."
Australia's current age of eligibility for bowel cancer screening tests is 45 years old.
During the election campaign, Christopher Luxon and Nicola Willis committed the National Party to matching that - "as workforce and fiscal conditions allowed".
Brown said the government still wanted to do that, but did not yet have a timeframe for achieving it.
"We want to go beyond 50 to 45 but what we're saying here is there's some critical limitations and we need to make sure Health NZ is building its capacity to do more colonoscopies in the community. As that is able to be done we will continue to lower that age over time."
Bowel Cancer NZ chief executive Peter Huskinson echoed the concerns about the government deciding not to lower the age for Māori and Pacific people.
"Around 100,000 Māori and Pacifica aged 50-58 now are excluded from the programmes," he said.
"So, although it's good for some. Overall it's a step backwards for equity and it's really far short of what people need.
"We have 400 excess deaths in New Zealand compared with Australia every year from bowel cancer."
New Zealand has more than 1200 deaths a year from the disease.
A question from Auckland woman Aimee-Rose Yates at a televised election leaders' debate in 2023 prompted Luxon to promise to drop the screening age.
She said she was disappointed by today's announcement.
"Initially, when I saw lowering the screening age, I thought, 'OK, we have a first step.'
"I know it's going to save lives, but it's also going to mean that there's an entire group of people [Māori and Pacific] that if they got diagnosed at 51, 52, 53, it now means that they could die because of this. We're sacrificing Peter to pay Paul."
Yates, who has terminal cancer, wants to know what would happen next.
"There is no next step. There is no, 'OK, we're starting with 58 then in five years we're going to move to 50, and then in five years we're going to move to 45.'
"It's really disappointing to hear that we just have this one little step and we have to hold on to that."
Cancer care advocate Melissa Vining said she was also underwhelmed, and she wondered about the effect on overworked hospital gastro departments.
"It's just incredibly disappointing to have a pre-election promise [unmet] that was pretty important to a lot of people and the bigger problem is that for symptomatic patients the waits in New Zealand are outrageous and clinically unsafe.
"When you bring in more screening that has a flow-on effect for those symptomatic patients they really need to be looking at resourcing this properly."
Patient voice Aotearoa chairman Malcolm Mulholland said it was concerning the announcement came on the same day pathologists, who analysed the screening tests, had announced another strike.
He echoed Vining's concern that the announcement lacked detail about its flow-on effects.
"What will actually happen if those tests will come back with a suspicion of bowel cancer. We know that surveillance colonoscopies have been paused at MidCentral and it's my understanding that services across the country aren't in great shape in the public sector."
Mulholland said he also failed to understand why the move to lower the age for Māori and Pacific people was scrapped.
