By Susana Leiataua, RNZ National presenter
The Aotearoa New Zealand government is being accused of sacrificing peoples’ lives for ideology by delaying bowel cancer screening for Māori and Pacific people from 50 to 58.
Pacific doctors say Health Minister Simeon Brown’s decision to make bowel screening free at the universal age of 58 for all New Zealanders goes against research data and evidence.
Sir Collin Tukuitonga, co-director of the Centre for Pacific and Global Health at Auckland University, said the policy change for the bowel cancer screening age was unsophisticated and deeply flawed.
Bowel screening age for Māori and Pacific people at the age of 50 was based on need, he said.
“Here is one time where we actually have good data to show that Māori and Pasifika people are at risk of bowel cancer at an earlier age,” Sir Collin said.
“In other words a clear demonstration of need and yet they’ve gone and dismantled a perfectly data-driven evidence-based policy. It’s a vote grab I think. It’s deeply flawed.”
When changing the bowel screening age to 58, the Health Minister said the incidence rate of bowel cancer was similar across all population groups in New Zealand, but Sir Collin said it occurred more among Māori and Pacific people.
Rate of Pacific occurrence higher
“For the bowel cancer incidence rate to be the same across ethnic groups, it tells me that for the minority groups the incidence is higher. In other words the rate of occurrence in Māori and Pacific adults is higher.
“That’s why you end up with the comparable occurrence. So clearly as I say this is a policy that is deeply flawed, relatively unsophisticated, driven by ideology not facts or evidence.”
Otago University research fellow and lecturer Dr Viliami Puloka said the government was putting business ahead of thousands of people’s lives by removing the earlier bowel screen age of 50 for Māori and Pacific people.
Early detection was the marker by which the bowel screening programme’s strength was measured, he said.
“Eight years — as they’re proposing for us to wait — by then we may not be able to do anything. We’ll just tell them to ‘Prepare your funeral because you’re already been developing the cancer for the five, eight years before we find out.’
“By the time it’s been diagnosed it’s too late for any intervention of any importance to be able to address that and that’s really the issue here.”
Dr Puloka predicted the new policy would see thousands of New Zealanders not receiving bowel screening, and most would be Māori and Pacific people.
“It is a matter of fact genetics is important. Social environment is important,” he said.
‘Ethnicity definitely major factor’
“There are a lot of social determinants of health and what might cause one to develop a disease even though they are living in the same country or even if they’re born of the same ethnicity, but ethnicity definitely is a major factor.”
Bowel Cancer New Zealand board member Rachel Afeaki knows the impact of bowel cancer screening.
Her mother died of bowel cancer and five years later her father was diagnosed with bowel cancer after a colonoscopy. He survived.
Afeaki called the government dropping the overall age of screening to 58 a “token move”.
“In 2023 the Census shows that there’s just over 38,000 Pasifika between the ages of 50 to 59 that were set to benefit from the age extension, and around 30,000 of these people will no longer be eligible as a result of these changes.
“And Pasifika people face a 63 percent higher mortality rate from bowel cancer than non-Māori non-Pacific people and it’s really important that this government recognises that a one size fits all screening age doesn’t work for a quarter of New Zealanders with Māori and Pacific peoples having been failed by this approach,” Afeaki said.
Bowel Cancer New Zealand would like to work with the health minister to try and meet the prime minister’s promise to screen from age 45, and screen 10 years earlier for Māori and Pasifika peoples, Afeaki said.
Timely, quality healthcare
In his response, Simeon Brown said that as Minister of Health, his priority was ensuring all New Zealanders had access to timely, quality healthcare.
“That means ensuring we can do the greatest number of treatments and preventions with the resources we have.”
Bowel cancer risk is similar across all population groups at the same age, he said.
“Advice from the Ministry of Health shows that by lowering the age of eligibility from 60 to 58 for all New Zealanders, we will be able do an extra 8479 tests and save an additional 176 lives over the next 25 years than would be the case if we only lowered eligibility for Māori and Pasifika from 60 to 50.
“Our government has also made a significant investment of $19 million over four years to make sure that we are targeting those population groups who have lower rates of screening, like Māori and Pasifika.
“This is a game changer and will save lives,” Brown said.
This article is republished under a community partnership agreement with RNZ.
