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Speaker 1: So we brought you the story last week of the

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Speaker 1: bow screening program. The government has moved to lower the

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Speaker 1: age for everybody from sixty down to fifty eight. Now

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Speaker 1: that has meant that they have cut a program that

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Speaker 1: was lowering the age from sixty down to fifty for

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Speaker 1: two particular ethnic groups, for Marty and Pacifica. Now, last

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Speaker 1: week I asked the Health Minister whether Marty and Pacifica

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Speaker 1: are more predisposed to getting bowel cancer at a younger age.

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Speaker 1: This is what he said.

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Speaker 2: No, the advice is that bowel cancer risk is similar

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Speaker 2: across all population groups at the same age, so that

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Speaker 2: that's the even right that we've presented by the Ministry

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Speaker 2: of Health.

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Speaker 1: So listening to that with some doctors who thought there

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Speaker 1: was something wrong. Matt Wheeler is with the Royal Australasian

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Speaker 1: College of Physicians. Matt, Hello, Killy, how are you get calder?

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Speaker 1: Thanks for being with me? Is that true?

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Speaker 3: From what I have seen? And I think the caveat

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Speaker 3: here is that I'm a hematologist. I'm not an oncologist,

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Speaker 3: but I'm also a general physician and so do work

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Speaker 3: quite significantly in diagnosing cancers. But from what I can

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Speaker 3: see from the experts, and this includes groups from the

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Speaker 3: University of Otago, Hey Yahood and Malway. That's not true

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Speaker 3: that the actual peak age of diagnosis of bow cancers

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Speaker 3: is earlier in Mary than non Marty, and that was

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Speaker 3: why the original screening program had bow screening down to

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Speaker 3: the age of fifty for Marty and Pacifica, yet had

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Speaker 3: the screening age stop its down to sixty for non

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Speaker 3: Marti populations. Because of the difference in an age of

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Speaker 3: diagnosis and the proportion of young diagnosises of bow cancer.

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Speaker 1: What you're saying is quite significant then, because basically you're

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Speaker 1: saying the Ministry of Health is wrong when they say

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Speaker 1: that bow cancer risk is similar. Doesn't matter what color

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Speaker 1: you are.

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Speaker 3: Yeah. One, and and there's there's plenty of publications and

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Speaker 3: groups that have previously said it. There's even a specific

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Speaker 3: report that was produced by the Marty Doctors Association called

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Speaker 3: the Order that specifically said that that percessible bowel cancers

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Speaker 3: were diagnosed in Marty under the age of sixty. And

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Speaker 3: there's there's some quite significant graphs out there that show

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Speaker 3: the peak and incidents is different from it's a non Marty.

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Speaker 1: So when the because the Minister says that this will

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Speaker 1: save an additional one hundred and seventy six lives over

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Speaker 1: twenty five years. You guys have put out a press

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Speaker 1: release today saying that this will cause more deaths. So

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Speaker 1: you can't both be right. So for anyone listening at home,

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Speaker 1: I mean, this is a bit of a stale mate,

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Speaker 1: isn't it.

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Speaker 3: Well, it's all about how you crunch the numbers. So

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Speaker 3: if you if you looked at the number of additional

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Speaker 3: beaks that would prevented over twenty five years for the

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Speaker 3: lowered age, which is down to fifty, you were actually

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Speaker 3: getting three hundred and ninety deaths that you would prevent

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Speaker 3: over twenty five years. That's three hundred and ninety people.

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Speaker 3: That's three hundred ninety five No, that would lose a

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Speaker 3: loved one. By changing the age for everyone down to

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Speaker 3: fifty eight, you prevent five hundred and sixty sixt deaths. Now,

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Speaker 3: that's simply because the non MLI population, including the mighty population,

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Speaker 3: by shifting that down to fifty eight, is just sheerly greater.

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Speaker 3: By talking the whole numbers, but isn't that the point

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Speaker 3: of a difference.

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Speaker 1: A public health system should try and do the greatest

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Speaker 1: good for the greatest number of people, should it not?

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Speaker 1: I mean, if you if you've got limited money and

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Speaker 1: you can save an additional one hundred and seventy six lives,

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Speaker 1: shouldn't you go with that option? Otherwise you I mean

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Speaker 1: you're saying you would kill more.

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Speaker 3: Well, the answer then is why aren't you doing both?

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Speaker 3: Because what you're what this isn't what we're not talking

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Speaker 3: here limited age standardization. So if you're well, but they've

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Speaker 3: said that there's money, and they've said they've said there's

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Speaker 3: money time and again, and that when when when the

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Speaker 3: need is required? And so when this is the difference

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Speaker 3: between equality and equity, and equality is about trying to

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Speaker 3: do the most good for the most number of people.

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Speaker 3: But that doesn't account for the fact that some people

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Speaker 3: get diagnosed with cancers ten years earlier than others. And

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Speaker 3: so what we do in health is we quite often

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Speaker 3: we talk about quality adjusted life years, and that's talking

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Speaker 3: about if you've got an age standardized rate where you're

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Speaker 3: diagnosed with things at a younger age, that that actually

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Speaker 3: for the amount of money that you're you're.

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Speaker 1: Getting get that. That's the other point that we're still

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Speaker 1: debating right now. Isn't it because the Ministry of Health

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Speaker 1: has said one thing about that particular issue and you've

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Speaker 1: got you're telling me today another. So we need to

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Speaker 1: go ask the Ministry of Health what the hell is

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Speaker 1: going on.

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Speaker 3: So one of the thing that we said in our

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Speaker 3: statement is show us you're working. Where is your where

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Speaker 3: is your evidence? Because we can cite studies that are

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Speaker 3: published in the medical literature that back up what I'm

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Speaker 3: necessary saying. And as I said, from groups from the

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Speaker 3: University of otarget.

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Speaker 1: We'll awesome, so well awesome, that well awesome because we

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Speaker 1: have to leave it here, but we will. We will

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Speaker 1: ask the Ministry of Health to tell us exactly how

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Speaker 1: they figured that out.

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Speaker 3: Appreciate And I think that's the question that we're necessarily

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Speaker 3: asking because if the advice is wrong, where the where

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Speaker 3: the college of specialties that deal with us that are

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Speaker 3: here to help as in how is needed?

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Speaker 1: All right, Matt, thanks your time, Matt Wheeler, Royal Australasian

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Speaker 1: College of Physicians. Now we have reached out to the

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Speaker 1: Ministry of Health. We've asked them to tell us basically,

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Speaker 1: show us you're working, How did you how did you

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Speaker 1: come to that conclusion? So we'll keep you updated on

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Speaker 1: what they have to say.

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