It is common to have no symptoms of bowel cancer. If you’re 45 and over, with no symptoms, international studies tell us the best way to keep a check on your bowel health is to do a screening test. If the test is positive a colonoscopy is the next step.
What does the screening test check for?
The screening test used in the pilot programme checks for blood in your stool, which may not be visible. It is a simple test that can be done at home which will produce one line for a negative result, and two for a positive one. There is no need to send samples to a lab with the associated long waits. Called a faecal immunochemical test (FIT), the test is very similar to a Covid-19 RAT test, and easy to do in the comfort of your own home. There’s no special diet or prep to do before the test and no long wait to get your results. Within minutes you will see either one red line (negative), or two red lines (positive) on the test cassette.
What happens if I get a positive test?
A positive result does not necessarily mean you have bowel cancer. The test can detect tiny traces of blood present in your bowel motion. There can be other reasons you have blood in your bowel like polyps or haemorrhoids (piles). The follow up with a colonoscopy is critical to look for pre-cancerous polyps or early bowel cancer. Picking it up early means it can be successfully treated. If the specialist finds a cancer you will be referred for treatment.
What happens if I get a negative test?
If your test is negative, this means you don’t need any further investigation at this time.
What does a colonoscopy involve?
A colonoscopy involves a doctor passing a thin tube into the bottom which is used to examine the lining of the bowel. This is performed under sedation. If a cancer is found a small sample or biopsy will be taken and if polyps (growths) are found they will generally be removed. The samples or removed polyps are sent to the laboratory for analysis. Polyps are not cancers, but may turn into a cancer over a number of years. Taking a biopsy or removing polyps does not usually cause discomfort.
Why are we starting at age 45?
Bowel cancer screening with a FIT test (stool test checking for microscopic blood) is recommended and supported from the age of 45. This is where the current evidence suggests there is the greatest benefit to patients as a whole.
Under 45 years old, bowel cancer is less common. The FIT test is more likely to be a false positive (i.e., the test is positive, but there is no bowel cancer or advanced polyps).
What if I have symptoms?
Although under 45 years old bowel cancer is less common, it is increasing in incidence.
Therefore, at any age, if you have new gut symptoms:
Abdominal pain or cramping
Bleeding from the bottom or visible blood mixed into the stool
A sustained change in your usual bowel habit (i.e., new constipation or diarrhoea)
Unexplained weight loss
Iron deficiency anaemia on a blood test from your GP (i.e. low blood count and iron level)
You should discuss this with your usual family doctor who may refer you on for further testing. This would not be with a FIT stool test.
If you have no symptoms, but have a family history of colon cancer, particularly in a first degree relative (i.e., Mum, Dad, sibling) it is suggested you get a colonoscopy at 10 years before they were diagnosed. For example, if your relative was diagnosed age 50, it is suggested to have a colonoscopy at 40.
How will this count against my policy?
The FIT kit and any nurse support is provided at no extra cost to you and won’t be registered as a claim against your policy. All other services (such as a colonoscopy) required will be claimed as per policy with normal rules applying including where applicable, co-payments, excesses, benefit limits and low claims discount adjustments.
Why have I specifically been chosen for this?
The criteria to take part is the following:
Must be a Southern Cross member
Must be between ages of 45-60
Must have a plan with surgical cover
Must not have had a colonoscopy in the past 5 years.
Based on our records you may meet the criteria and have been selected at random to join.
Why am I the only member of my family who has received this invite?
We are piloting a new way of helping members proactively look after their bowel health. Members who meet the criteria have been identified and then randomly chosen to be invited into the pilot. This is why in some circumstances only one eligible member of a family has been invited to join. If this pilot is successful we may look to make this available for all our members who meet the eligibility criteria.
My friend / family got invited to this, why can’t I join?
Invitations were sent out randomly to a limited group of eligible members. While this programme is in the pilot phase, we are keeping the scope of the project small so we can test, learn, and hopefully make improvements to our member offering in the near future.
Why do I have to go to the specified endoscopy clinic?
We are piloting a new way of providing bowel health services and have partnered with the specific clinics in each respective region to provide this service. If you have a positive result on your FIT and wish to see a different endoscopist you may do so and claim from your policy, but this will be outside of the pilot and as per our usual processes. A MedPro nurse will support you to get referred elsewhere and your chosen endoscopy clinic will apply for prior approval on your behalf.
We are working with Southern Cross Healthcare, MedPro, Waitemata Endoscopy, Rutherford Clinic, Southern Endoscopy and respective Colorectal surgeons in the relevant regions to deliver this pilot.
How will you be using my health information and data during this pilot?
Your health information relevant to the pilot may be shared between Southern Cross Healthcare, MedPro, colonoscopy clinics and other providers who are involved in your care such as imaging clinics and specialists. The information will only be used for the purposes of administering, reporting and evaluation of the pilot. Medpro will collate clinical results from all those involved in your care and present them to Southern Cross in de-identified form. Please see our full privacy statement for more details about how your information will be managed.
This sounds like a screening programme; I thought screening was excluded under Southern Cross policies?
The screening component of the pilot is being paid for outside of policy. We are always looking to test ways in which we can enhance of membership offering and we hope to learn from this pilot and improve our policies as a result.
Screening is a general exclusion under our policies (with some exceptions). Colonoscopy for screening purposes is currently an exclusion, except in very specific circumstances. Please see here for more information.
Any further questions?
If you have any questions about your own bowel health or want more information on the Bowel health pilot programme, please contact 0800 MEDPRO (633776) or 09 838 3555.