One in four New Zealanders can’t yet spontaneously
name a single symptom of bowel cancer – and even the most
common red flags are flying under the radar.
New
research from Bowel Cancer New Zealand reveals a critical
gap in public awareness of the country’s second-deadliest
cancer, with one in four adults unable to name a
single symptom of bowel cancer without prompting.
That figure jumps to 41% among under-30s,
despite rising rates of bowel cancer in younger Kiwis[i].
The
nationally representative survey of more than 1,250 adults
– the first major study into bowel cancer awareness in New
Zealand – also found that just one in five people
(21%) feel well informed about bowel cancer. Even
among those aged 60 and over, who have reached the
eligibility age for screening, nearly three-quarters
(72%) said they don’t feel well
informed.
“Bowel cancer is the
second-highest cause of cancer death in New Zealand, but it
shouldn’t be,” says Peter Huskinson, Chief Executive of
Bowel Cancer NZ. “It’s beatable and treatable if caught
early. Awareness is the first step toward prevention, but
right now, too many Kiwis are in the dark,” he
says.
Symptom blind spots a cause for
concern
While blood in your poo was the most
commonly-recalled symptom, it was named by just 40% of
people without prompting. One in five (21%) spontaneously
mentioned abdominal pain as a potential warning sign,
however just 14% spontaneously mentioned a change in bowel
habits, despite it being just as common a symptom as blood
in the stool in people who are diagnosed with bowel
cancer.
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Fewer than one in ten New Zealanders
spontaneously identified symptoms such as bleeding from the
bottom (9%), unexplained weight loss (9%) or fatigue (just
5%). Even when prompted, many people failed to clearly
connect these symptoms to bowel cancer
risk.
“Symptoms like fatigue, weight loss or
bowel habit changes can be easy to ignore or attribute to
something else – but they could be a warning
sign,” says Sue Crengle, GP and Bowel
Cancer NZ Medical Advisor. “Knowing what
to look for, and seeing your GP if something’s not right,
is critical.”
Cost and uncertainty keeping
Kiwis with symptoms from the GP
The survey also
revealed several key barriers stopping or delaying people
from seeing their doctor if they notice or were concerned
about potential symptoms. Symptom uncertainty was one of the
most commonly cited, with 26% unsure about symptoms and
whether they needed a check-up and 23% unsure about severity
of symptoms and whether they warranted a doctor’s
visit.
Cost was also a key barrier to seeing a doctor,
cited by 22% of respondents – rising to one in three among
under-45s. This trend was consistent across incomes and
ethnicities.
“It’s deeply concerning that cost
could stop someone from getting checked for bowel cancer
symptoms,” says Crengle. “We need to make it easier, not
harder, for people to act early – that means better
awareness, and more affordable access to primary
care.
A further 13% said embarrassment or discomfort
discussing bowel issues would put them off seeking
help.
People under 45 were also the least likely to
act. Fewer than 60% said they’d be “very likely” to
see a doctor if they noticed symptoms, compared to more than
80% of those aged 60+.
Bowel Cancer NZ ambassador Dean
Barker, diagnosed at age 46, says recognising symptoms and
acting early made all the difference.
While training
with his America’s Cup team in the US, he noticed blood in
his stool. After a couple of weeks of hoping the problem was
going to go away, Dean saw a doctor – a decision that led
to early diagnosis and ultimately successful
treatment.
“This research shows there is still work
to be done when it comes to recognising the signs of bowel
cancer and acting on it,” says Barker. “Don’t sit on
your symptoms. Know what to look for and if something
doesn’t feel right, don’t tough it out or put if off –
get it checked.”
Screening: The best-kept secret in
cancer prevention
Despite its life-saving potential,
many New Zealanders remain unaware that bowel screening can
prevent cancer, not just detect it.
Only 11%
of those not recently exposed to Bowel Cancer NZ
messaging knew this. Among those who had recently
seen or heard from the charity, spontaneous awareness for
this as a way of reducing the risk for bowel cancer more
than doubled to 26%. Media exposure also significantly
boosted knowledge.
“That free test in your mailbox
doesn’t just detect cancer – it can stop it before it
starts,” says Huskinson. “Don’t leave it in a drawer.
Put it by the loo and get it done.”
David Downs
knows the value of early screening. At 54, he was at an age
doctors agree screening is needed, but below the
Government’s eligibility age of 58. Having survived other
cancer, he opted to purchase a test privately due to past
concerns. Two weeks later, results flagged an elevated risk.
A follow-up colonoscopy found 10 pre-cancerous
polyps.
“Had I waited another six years until I was
eligible, I could have had serious issues,” says
Downs.
His story highlights why lowering the national
screening age is so critical – not everyone can afford to
wait, or to pay.
When screening isn’t an
option, symptom awareness and action are even more
critical
More than 3,300 Kiwis are diagnosed
with bowel cancer every year, and 1,200 will die from
it.
“That’s a tragedy – because we know that an
early diagnosis saves lives,” Huskinson says. “With
screening currently limited to those aged 58 and over,
symptom awareness remains our strongest line of defence.
Acting early, before symptoms become severe, can mean the
difference between a treatable diagnosis at the GP and a
late-stage emergency presentation.”
Far too many New
Zealanders are being diagnosed in emergency departments –
often when the cancer is more advanced and harder to treat.
In New Zealand, more than one in four bowel cancer cases
(26%) are detected this way, compared to 18% in the UK[ii].
The
picture is even worse for Māori and Pacific peoples. Within
New Zealand, 35% of Māori and 44% of Pacific peoples are
diagnosed in emergency settings, compared to 28% of Asian
people and 25% of New Zealand European and other
ethnicities.
“Everyone in Aotearoa cares about
health and wants to stay cancer free, but first people need
to know what to look out for. That’s why we are committed
to making symptom awareness part of the national
conversation. If something doesn’t feel right, don’t
wait. Talk to your GP. No one ever died of embarrassment –
but they do die of bowel cancer,” concludes
Huskinson.
Don’t sit on your symptoms
Fill
out Bowel Cancer NZ’s simple symptom checker at https://bowelcancernz.org.nz/check-your-symptoms/.
If you notice any of the signs below, don’t ignore
them:
- Bleeding from the bottom or in your
poo - A persistent change in bowel
habits - Ongoing, periodic, or severe abdominal
pain - Unexplained weight loss or fatigue
- A
lump or swelling in the
abdomen
Notes:
[i]
BMC Cancer. 2024;24(1):456. Waddell O et al. “The
incidence of early onset colorectal cancer in Aotearoa New
Zealand” https://bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12122-y
[ii]
National Bowel Cancer Audit (NBOCA). Annual
Report 2021. Available at: https://www.nboca.org.uk/wp-content/uploads/2022/02/NBOCA-2021-AR-Final.pdf
and Bowel Cancer Quality Improvement
Report. Auckland DHB and Health Quality &
Safety Commission New Zealand, March
2019.
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