A leading cancer specialist says lowering the age for free bowel cancer screening will save lives, but warns the Government’s decision not to introduce earlier screening for Māori and Pacific peoples risks deepening health inequities.
Associate Professor George Laking, from the University of Auckland’s Te Aka Mātauranga Matepukupuku, Centre for Cancer Research, says moving the national eligibility age from 58 to 56 is a positive step, but it does not go far enough for communities already carrying the heaviest cancer burden.
Bowel cancer remains a major contributor to the seven-year life expectancy gap between Māori and non-Māori. Māori are more likely to be diagnosed later, more likely to face barriers to timely treatment, and more likely to experience poorer outcomes after diagnosis.
Health experts say the inequity does not end once cancer is found. Māori patients can face delays in referral, diagnosis, surgery, chemotherapy and follow-up care. Access to specialists, transport, cost, distance from services, and culturally unsafe healthcare environments can all affect survival.
Associate Professor Laking’s concerns centre on equity. Earlier screening from age 50 had been proposed for Māori and Pacific peoples because bowel cancer can appear earlier in these communities. Removing that approach means some people at higher risk may not be reached until their cancer is more advanced.
The issue is not only individual behaviour, but the way the health system is designed. Māori health advocates have long pointed to institutional bias, under-resourced services, poorer access to primary care, and a lack of Māori-led cancer pathways as key drivers of unequal outcomes.
Lowering the age to 56 may help some people get screened earlier, but experts say a universal age setting can still miss those who need targeted support most. For Māori and Pacific peoples, the difference between screening at 50 and screening years later could be the difference between early treatment and a life-threatening diagnosis.
Policy changes being called for include restoring bowel screening from age 50 for Māori and Pacific peoples, stronger investment in Māori and Pacific health providers, better follow-up after positive tests, faster access to colonoscopy, and cancer services that are culturally safe from screening through to treatment and survivorship.
Health leaders say improving survival rates will require more than expanding eligibility. It will require a system that actively removes barriers, prioritises those with the greatest need, and measures success by whether inequities are closing.
For Māori whānau, bowel cancer is not just a medical issue. It is a question of fairness, access and the right to live longer, healthier lives.
