Free bowel screening now starts at 56, but only in some regions

If you're 56 or 57, whether you can get a free bowel screening kit now depends on where you live.

This week the starting age for the national bowel screening programme dropped from 58 to 56. Health Minister Simeon Brown said in a press release that the change applies first in Auckland, Waikato, Gisborne, Wairarapa, the West Coast and South Canterbury. Everyone else follows in April next year.

Health NZ has an online checker for bowel screening eligibility at healthnz.govt.nz. It will tell you whether your district is in the first group, so you know whether to expect a kit now or next April.

The test itself hasn't changed. It's a test you do at home. Eligible people get a free one every two years until they turn 75. If the result is positive, you're offered a follow-up, usually a colonoscopy.

Brown said the lower age will give more than 200,000 more New Zealanders access to screening over the next two to three years. The Budget 2026 money behind it is $45.6 million, which he said pays for hundreds of thousands of extra kits and more than 6,200 extra colonoscopies over four years. The Government expects the change to prevent 638 more bowel cancers and save 522 more lives over 25 years.

Bowel cancer kills more than 1,200 New Zealanders a year, making it the country's second-biggest cancer killer, Brown said. He called the age change "the next step towards matching Australia".

Since the age dropped from 60 to 58 last year, about three-quarters of newly eligible 58- and 59-year-olds have been invited, according to the Government. Of those, 1,320 returned a positive result and 37 cancers were found.

Brown said the programme is being widened in stages so services have the staff and endoscopy capacity to safely handle more people.

Pathologists say their part of the system is being left out of that planning. The NZ Herald reported that Associate Professor Diane Kenwright, the Royal College of Pathologists of Australasia's vice-president for New Zealand, warns the pathology workforce is "at a cliff edge". She told the Herald the profession is 30 specialists short and has an ageing workforce. Urgent cases that should be processed within 48 hours are taking up to two weeks, she said. And no money has been set aside for more pathologists as screening grows.

The college wants $3.7 million a year to fund 23 pathology training places. It says it put that to health officials almost a year ago and was told no money was immediately available.

Screening generates lab work beyond the colonoscopy itself. The Herald cited a Health NZ strategy document saying more screening would increase demand on cytology, colonoscopies and anatomical pathology, the specialty that examines tissue samples.

Bowel screening isn't the only programme getting bigger. From March next year, cervical screening becomes free for another 786,000 eligible women, the Herald reported. That lands on labs one month before the rest of the country moves to the lower bowel screening age.

Brown told the Herald that a $65 million boost last year let the Government beat its targets, with more than 89,000 procedures across radiology, colonoscopy, cardiac and colposcopy services. He said Health NZ is talking with pathologists to "understand and confirm" funding requirements. Neither source says whether new money for pathology training is coming, or when.

None of this affects people who already have symptoms. Screening kits are for people who feel well. A separate route, the FIT for Symptomatic pathway, went nationwide in July, according to Brown's release. Health NZ expects it to cut colonoscopy referrals for people with symptoms by up to 30 per cent.