Helping patients at risk of bowel cancer

Thursday, 1 October 2015 by Helen King


Bowel cancer is the second highest killer of New Zealanders, after heart disease, with an estimated 7 per cent of Kiwis likely to develop it (source: Bowel Cancer New Zealand). However, the majority of people with bowel cancer can be completely cured if diagnosed and treated in time.

A leading expert in the field, and Southern Cross Affiliated Provider, Dr Michael Schultz says, “Survival is very tightly correlated with the stage of cancer. You can easily cure someone with surgery and aggressive chemotherapy if the cancer is found in the early stages. Screening is the only method to find the early cancers and polyps that can turn into cancer”.

Colonoscopy is the most effective method of screening. Under Southern Cross policies screening is an exclusion for cover. However screening and surveillance colonoscopies are an exception if eligibility criteria are met by the member concerned.

Southern Cross Health Society figures show, cost-wise, colonoscopy is the third most claimed for procedure. There is also a high demand in the public system – often outweighing capacity.

Dr Schultz says addressing this need was the thinking behind an initiative last year where $75,000 was set aside to provide 50 free colonoscopies over four days to Central Otago and Queenstown Lakes patients.

“We found that all local GPs had patients waiting who either couldn’t get a colonoscopy through the public system or couldn’t afford one privately. Considering that a key hurdle to combating bowel cancer is how soon it’s picked up, this just highlights the disparity between public capacity and need,” says Dr Schultz.

“Bowel cancer is one of these unfair things because it can either cause lots of symptoms early on or no symptoms at all . It’s extremely difficult to predict who has bowel cancer and who doesn’t without investigation,” Dr Schultz notes.

Although Dr Schultz does recognise talking about bowel health can be an awkward topic for patients he considers it is too serious an issue to be shy about.

“Ask your patients about any family history of bowel cancers, ask them about symptoms because these things are not being talked about. I think on a yearly basis GPs should askquestions like: ‘How do your bowels work?’ ‘Are you seeing any blood or mucous?’ ‘Is there any unintended weight loss?’ ” he adds.

The picture isn’t clear yet as to why New Zealanders have such high rates of bowel cancer. However Dr Schultz points out that studies usual repeat the same story - genetic pre-disposition and lifestyle factors. “But the only thing that really stands out in all of these studies is it is more common in those who eat a lot of barbequed meat and red meat.”

Dr Schultz has helped develop a calculator to identify a person’s risk of developing bowel cancer depending on the family history
http://ecrc-system-ghn.appspot.com/. The recommendations are based on and in agreement with NZ Guidelines Group.

Dr Schultz is a Gastroenterologist with the Southern District Health Board, an Associate Professor of Medicine at Otago University and runs private clinics at Mercy Hospital Dunedin, Marinoto Clinic and in Wanaka and Central Otago.

Contact Dr Schultz,

Suite 7 Marinoto Clinic,72 Newington Avenue, Dunedin 9010

T 03 471 6653 F 03 471 6655 E suite7@marinoto.co.nz

Disclaimer: the views expressed in this article are those of the individual identified and do not necessarily represent the views of Southern Cross Medical Care Society.