New Survey Reveals Major Gaps In Awareness Of Bowel Cancer Symptoms
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.
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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