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Colorectal screening needs "obsession" with quality control

University of Otago

Saturday 31 May 2008, 1:04AM

By University of Otago

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WELLINGTON

University of Otago Wellington public health researchers have are welcoming the Minister of Health's announcement of a colorectal cancer screening programme.

The Public Health Medicine specialists and senior researchers, Drs Caroline Shaw and Diana Sarfati, say international evidence demonstrates that a well-run population screening programme for colorectal cancer screening can decrease death rates from colorectal cancer by about 16 per cent.

Dr Shaw says New Zealand is in a good position to learn from overseas countries about what works and what does not work.

"However setting up a screening programme is a very complicated business. We need to make sure we have all the components in place to ensure the programme can deliver on the health benefits."

"We need mechanisms in place to identify and invite in those who should be screened. We need enough staff to provide colonoscopies for all those people who have a positive screening test, as well as making sure that people who need colonoscopies for other reasons do not have to wait longer than they currently do. We also need a commitment that all population groups in New Zealand will be equally well served by the screening programme. In effect, we need to be obsessed with quality control in all parts of the screening programme, if it's to be safe and effective."

Dr Sarfati says New Zealand's previous experience with cervical and breast screening has shown us that screening programmes take a long time to get up and running.

"While – theoretically – it would be great to have a programme starting next week, we know that we will only reap the benefits of colorectal cancer screening if all these key aspects are in place. Achieving that will take considerable time and effort. Other countries with colorectal cancer screening programmes are phasing them in over a prolonged time period. For example, it will take 10 years in Finland and probably a similar length of time in the United Kingdom before everyone who is eligible will be offered screening."