title: Prospects for population colorectal cancer screening in New Zealand.
abstract: OBJECTIVE
  In 2005 the National Screening Unit of the Ministry of Health appointed a Colorectal Screening Advisory Group to provide independent strategic advice and recommendations on population screening for colorectal cancer (CRC) in New Zealand.
  
  
  METHODS
  Evidence-based review of relevant literature and assessment of CRC screening using the New Zealand Criteria to Assess Screening Programmes.
  
  
  RESULTS
  Guaiac faecal occult blood test (FOBTg), immunochemical FOBT (FOBTi), flexible sigmoidoscopy, colonoscopy, and CT colonography were considered. FOBTg is the only test supported by high quality evidence from randomised controlled trials but has limited sensitivity and achieves modest CRC mortality reduction over time. FOBTi has higher analytical sensitivity than FOBTg and would be assumed to achieve greater mortality reduction. A CRC screening programme requires substantial planning and resources. Currently public hospitals cannot deliver timely diagnostic or surveillance colonoscopy.
  
  
  CONCLUSIONS
  The Advisory Group recommends that a feasibility study of CRC screening using FOBTi be undertaken. This would help determine the performance of the FOBTi in the New Zealand population and whether the New Zealand health system could support an acceptable, effective and economically efficient CRC screening programme. To optimise the diagnosis and treatment of colorectal cancer there is an immediate need to expand colonoscopy services and to ensure that throughout New Zealand the treatment outcomes for CRC, both surgical and oncological, meet international standards.
authors.affiliation: Middlemore Hospital, Otahuhu, Auckland. sparry@middlemore.co.nz
authors.forename: Susan
authors.initials: S
authors.lastname: Parry
authors.forename: Ann
authors.initials: A
authors.lastname: Richardson
authors.forename: Terri
authors.initials: T
authors.lastname: Green
authors.forename: Betsy
authors.initials: B
authors.lastname: Marshall
authors.forename: Ian
authors.initials: I
authors.lastname: Bissett
authors.forename: Ashley
authors.initials: A
authors.lastname: Bloomfield
authors.forename: Vinton
authors.initials: V
authors.lastname: Chadwick
authors.forename: Chris
authors.initials: C
authors.lastname: Cunningham
authors.forename: Michael
authors.initials: M
authors.lastname: Findlay
authors.forename: Barbara
authors.initials: B
authors.lastname: Greer
authors.forename: John
authors.initials: J
authors.lastname: McMenamin
authors.forename: Judi
authors.initials: J
authors.lastname: Strid
authors.forename: Greg
authors.initials: G
authors.lastname: Robertson
authors.forename: Clinton
authors.initials: C
authors.lastname: Teague
mesh_terms: D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D006801:Humans; D008403:Mass Screening / Q000639:trends; D009520:New Zealand; D009780:Occult Blood