Each year in New Zealand, bowel cancer kills over 1200 people.1 Pre-cancerous polyps and early bowel cancers can both be successfully detected and treated at an early stage using a combination of faecal occult blood testing (FOBT) and colonoscopy, often avoiding the major risks of bowel surgery. These procedures are successfully preventing thousands of deaths from bowel cancer all around the world today.In 2005, The Australian Government National Health and Medical Research Council2recommended the introduction of organised screening with home-based faecal occult blood testing (FOBT), to be performed once every 2 years, for the well Australian population over 50 years of age.In 2008, the Australian Government Department of Health and Ageing3 introduced free bowel cancer screening. This programme involves sending free FOBT kits to people at home as their 50th, 55th, and 65th birthdays are recognised by Medicare. The Australian Cancer Council4 is currently conducting a campaign to encourage the Australian Government to broaden this programme to offer well over 50-year-old Australians free 2-yearly bowel cancer screening.The United States Preventive Services Task Force5 also recommends screening for colorectal cancer using FOBT, sigmoidoscopy, or colonoscopy, in adults, from age 50 to 75 (and up to age 85 for those who are very fit). Their recommendation is partly based on research6 that was published 17 years ago which showed a 33% reduction in death rate by FOBT screening.The National Health Service in Britain is currently rolling out a bowel cancer screening programme across the UK. For example, Bowel Screening Wales7 offers bowel screening to men and women every 2 years. Initially, people aged between 60 and 69 are being invited, and by 2015, the programme will be extended to invite everyone aged between 50 and 74.A large trial conducted across Britain8 has just demonstrated a massive 43% reduction in deaths from bowel cancer, after performing a single flexible sigmoidoscopy in asymptomatic men and women aged 55 to 64.In 1985, the world's largest single aircraft accident occurred when a Boeing 747 in Japan crashed killing 520 people on board. However, each year in New Zealand we accept the same number of people dying from bowel cancer (520) who could have been saved if a single flexible sigmoidoscopy had been performed once in their middle years (43% of 1200).We don't need a pilot programme. The only pilot we need is someone with the courage and funding to roll out a national FOBT and/or flexible sigmoidoscopy programme to save over 500 Kiwi lives each year!Therefore, what are we waiting for? How long are we going to put up with this completely preventable loss of life? Would the decision-makers and funders please just get on with it! Guy Hingston Surgical Oncologist Port Macquarie, NSW, Australia

Each year in New Zealand, bowel cancer kills over 1200 people.1 Pre-cancerous polyps and early bowel cancers can both be successfully detected and treated at an early stage using a combination of faecal occult blood testing (FOBT) and colonoscopy, often avoiding the major risks of bowel surgery. These procedures are successfully preventing thousands of deaths from bowel cancer all around the world today.In 2005, The Australian Government National Health and Medical Research Council2recommended the introduction of organised screening with home-based faecal occult blood testing (FOBT), to be performed once every 2 years, for the well Australian population over 50 years of age.In 2008, the Australian Government Department of Health and Ageing3 introduced free bowel cancer screening. This programme involves sending free FOBT kits to people at home as their 50th, 55th, and 65th birthdays are recognised by Medicare. The Australian Cancer Council4 is currently conducting a campaign to encourage the Australian Government to broaden this programme to offer well over 50-year-old Australians free 2-yearly bowel cancer screening.The United States Preventive Services Task Force5 also recommends screening for colorectal cancer using FOBT, sigmoidoscopy, or colonoscopy, in adults, from age 50 to 75 (and up to age 85 for those who are very fit). Their recommendation is partly based on research6 that was published 17 years ago which showed a 33% reduction in death rate by FOBT screening.The National Health Service in Britain is currently rolling out a bowel cancer screening programme across the UK. For example, Bowel Screening Wales7 offers bowel screening to men and women every 2 years. Initially, people aged between 60 and 69 are being invited, and by 2015, the programme will be extended to invite everyone aged between 50 and 74.A large trial conducted across Britain8 has just demonstrated a massive 43% reduction in deaths from bowel cancer, after performing a single flexible sigmoidoscopy in asymptomatic men and women aged 55 to 64.In 1985, the world's largest single aircraft accident occurred when a Boeing 747 in Japan crashed killing 520 people on board. However, each year in New Zealand we accept the same number of people dying from bowel cancer (520) who could have been saved if a single flexible sigmoidoscopy had been performed once in their middle years (43% of 1200).We don't need a pilot programme. The only pilot we need is someone with the courage and funding to roll out a national FOBT and/or flexible sigmoidoscopy programme to save over 500 Kiwi lives each year!Therefore, what are we waiting for? How long are we going to put up with this completely preventable loss of life? Would the decision-makers and funders please just get on with it! Guy Hingston Surgical Oncologist Port Macquarie, NSW, Australia