“Key hole” surgery for colon cancer resection colectomy has some benefits compared to equivalent open surgery. However, most data comes from specialist colorectal units. We compared the outcomes of laparoscopic colectomy in a provincial New Zealand hospital with those from specialist centres. Short term outcomes were shown to be equivalent.

Diet is an important risk factor for colorectal cancer, and there is growing evidence that what you eat following diagnosis can impact on your chances of survival. Despite this, few patients with colon and rectal cancer know specifics about how important their diet may be. Our survey examined what information people with colorectal cancer currently receive, and what information they feel they need. We found that less than a third of patients received specific dietary advice following a diagnosis of colorectal cancer, and that 98% of people wanted more information than they currently received. Major sources of information are presently friends and dietitians, but not patients doctors or nurses. As an outcome of this study, we have developed a comprehensive dietary information resource available for patients diagnosed with colorectal cancer.

Colorectal (bowel) cancer is the second most common cancer in New Zealand. International research has suggests that eating a diet high in meat, fat and refined grains intake, and low in fruit and vegetables, is associated with an increased risk of getting colorectal cancer. Recent research has also suggested that eating like this after having surgery to remove a colon or rectal cancer may increase the risk of the cancer coming back again. We surveyed 29 patients from Auckland who had recently had surgery to remove a colon or rectal cancer. We asked about what foods they eat regularly and if they had received any information about what they should eat after their surgery. Over 50% reported that they did not receive any dietary information after surgery. Many of the patients did not eat the recommended daily amount of fruit and vegetables as per the New Zealand Food and Nutrition Guideline statements for healthy adults. We recommend that patients with colorectal cancer be provided with more information on what is good for them to eat.

Vitamin D has been found to play a role in many diseases including colorectal cancer. Colorectal cancer occurs with a high frequency in the New Zealand (NZ) population, our research is a preliminary study in a NZ colorectal cancer population to test whether variants of the vitamin D receptor gene are linked to the occurrence of this disease. We could not find any statistically significant association.

Polyps are small growths in the bowel that over time can turn into bowel cancers. Removal of polyps using a colonoscope can reduce the risk of bowel cancer. International recommendations have been that the colonoscope should be removed from the end of the bowel in at least 6 minutes. Taking at least 6 minutes has been shown to result in more polyps being found and removed. Our study showed that the mean colonoscopy withdrawal time was 3 minutes 16 seconds. Colonoscopies in general are performed too quickly and should be performed slower.

Colorectal cancer (CRC) is the second most common cause of cancer death in New Zealand. Barium enema and colonoscopy have been the traditional investigations used in the work up of patients presenting with symptoms suggestive of CRC. Increasingly, computed tomographic colonography (CTC) is displacing barium enema as a non-invasive rapid imaging technique to investigate these patients. This study has reviewed the local data on rates of detection of colonic pathology and it suggests Māori and Pacific Islanders need encouragement from primary health practitioners to present for bowel examination. CTC is a safe, accurate, and non-invasive testing modality for CRC.

A review of findings at CT Colonography, (CTC) “Virtual Colonoscopy” was performed in over 2000 studies, mainly performed for patents with bowel symptoms. The vast majority did not have a sinister finding; 10.7% of the group required referral for an invasive test to remove a bowel polyp or assess further for malignancy. Findings outside the bowel (extracolonic findings) were also reviewed, and over half of all patients’ had an extracolonic finding reported. However these were almost all of non urgent significance, such as cysts or small renal stones. Only 8.3% of the group required further work-up recommendations to assess an important finding such as a large aortic aneurysm or possible cancer of lymph nodes or kidney. The results of this study are in line with other research in New Zealand and internationally.

There is a growing disparity between the colorectal cancer incidence rates of Maori and non-Maori in New Zealand. This research explored with Maori health workers their experiences with patients/whānau in navigating through the health system in terms of health screening programmes. This research assists us to understand how the new colorectal screening programme may work to be inclusive of Maori and assist in reducing health disparities within this area.

A national screening programme for bowel cancer has been recommended for New Zealand. This involves a test called the faecal occult blood test (FOBTi or FIT) which would be offered to people aged 50–74 every 2 years. The test is not 100% accurate and if it shows positive, a colonoscopy which is a complete examination of the bowel, is required to determine presence of cancer (or ‘adenomas’ which could develop into cancer). Colonoscopies are also required to monitor adenomas found. This paper estimates the volume of colonoscopies required if a national bowel screening programme using the immunochemical faecal occult blood test (FOBTi) for the initial screen for people aged 50–74 (currently being piloted in Waitemata) is introduced in New Zealand. A national bowel cancer screening programme will require a large volume of colonoscopies, estimated at 18,000 in the first year rising to 28,000 after 20 years. Services will need to expand to meet this demand, in order to deliver the colonoscopies following a positive FOBTi, in a timely fashion to confirm diagnosis, whilst also maintaining services for people with symptoms, or at higher risk. Monitoring of small adenomas will need to be carefully managed.