WEBVTT - Why critics call the Government’s latest bowel screening policy ‘pathetic’ 0:00:04.160 --> 0:00:04.640 Kiaoda. 0:00:04.640 --> 0:00:07.680 I'm Chelsea Daniels and this is the Front Page, a 0:00:07.760 --> 0:00:18.520 daily podcast presented by the New Zealand Herald. Bowel cancer 0:00:18.640 --> 0:00:22.160 is the second highest cause of cancer death in New Zealand. 0:00:22.560 --> 0:00:26.119 One in ten Kiwis diagnosed are under fifty, and every 0:00:26.239 --> 0:00:30.200 day around three New Zealanders die from bow cancer. Now 0:00:30.280 --> 0:00:32.080 keep those figures in mind when I tell you that 0:00:32.240 --> 0:00:35.360 Health Minister Simeon Brown has announced the government is lowering 0:00:35.400 --> 0:00:38.559 the screening from sixty to fifty eight for all Kiwis 0:00:38.960 --> 0:00:42.000 and canned plans to lower the age for Maldi and 0:00:42.000 --> 0:00:45.680 Pacific men to fifty. That might be a good fit 0:00:45.800 --> 0:00:49.040 for the Pakiha majority, but less so for Maldi and Pacific, 0:00:49.080 --> 0:00:53.000 given more of those groups developed cancer earlier. For example, 0:00:53.120 --> 0:00:56.280 about twenty six percent of bowel cancers and Pacific peoples 0:00:56.280 --> 0:00:59.000 occur between fifty and fifty nine years old, compared to 0:00:59.080 --> 0:01:03.040 about eleven percent for non multi or Pacific populations. Today 0:01:03.080 --> 0:01:05.880 on the front page, University of the Targo professor of 0:01:05.920 --> 0:01:10.360 colorectal surgery, Frank Brazell joins us to discuss what needs 0:01:10.400 --> 0:01:20.240 to be done to prevent this disease. Frank, you wrote 0:01:20.280 --> 0:01:24.280 a pretty scathing editorial in the latest issue of the 0:01:24.319 --> 0:01:26.720 New Zealand Medical Journal, tell me about it. 0:01:26.840 --> 0:01:29.319 The Ministry Health on the sixth to March announced the 0:01:29.959 --> 0:01:33.199 changes to the bow screening and has reduced it from 0:01:33.240 --> 0:01:36.479 sixty to fifty eight. This seems to be the least 0:01:36.680 --> 0:01:39.960 possible that he can do. When the Prime Minister in 0:01:40.040 --> 0:01:44.920 the pre election TV interviews, when they have those leader's debates, 0:01:45.200 --> 0:01:47.520 it's said they were reduced to the same as Australia. 0:01:48.160 --> 0:01:51.480 Sitting our audience right up there is Amy Rose Yates. 0:01:51.680 --> 0:01:55.920 She's got stage four terminal bowl cancer and she's in 0:01:55.920 --> 0:01:59.880 her early thirties. The national age for screening in this 0:02:00.080 --> 0:02:04.280 country is sixty. Her question is will either of you 0:02:04.680 --> 0:02:08.799 lower the age of screening and save the lives of Kiwis? 0:02:09.240 --> 0:02:11.359 Yeah, I'd like to do that, and we've also said 0:02:11.360 --> 0:02:13.200 we'd like to do it. On breast cancer screening, we're 0:02:13.200 --> 0:02:15.400 extending it from sixty nine to seventy four. Saving sixty 0:02:15.440 --> 0:02:17.240 five lives makes sense that we should do the same 0:02:17.240 --> 0:02:17.800 on bell cancer. 0:02:17.840 --> 0:02:19.000 So what will you bring it? 0:02:22.080 --> 0:02:25.160 Because lady, here's the problem, right, we have a fifteen 0:02:25.160 --> 0:02:28.880 percent higher mortality rate on cancer than the equivalents in Australia. Do, 0:02:29.200 --> 0:02:31.280 and so we actually have to close that cancer gap 0:02:31.360 --> 0:02:31.880 big time. 0:02:32.080 --> 0:02:33.919 Okay, so the bowel cancer screen do you want to 0:02:33.919 --> 0:02:35.840 bring it down as well? Chris sippins, Well, yes, absolutely 0:02:35.919 --> 0:02:37.760 I do, so you'll make that commitment to bring it 0:02:37.800 --> 0:02:39.880 down absolutely now. 0:02:39.919 --> 0:02:43.160 Australia at that time head it down to fifty and 0:02:43.440 --> 0:02:46.160 also was possible to get it from forty five by 0:02:46.200 --> 0:02:48.320 having a discussion with your GP about the pros and 0:02:48.360 --> 0:02:50.600 cons screening and then the GP will send your name 0:02:50.680 --> 0:02:54.440 through for you to be screened if it was appropriate. 0:02:54.760 --> 0:02:58.040 Australia has subsequently moved to forty five for everyone and 0:02:58.680 --> 0:03:00.920 you can actually get it done four by having that 0:03:00.960 --> 0:03:03.600 same discussion that previously you had to have. From forty five. 0:03:03.800 --> 0:03:06.639 Australia has moved a lot. You's moved a little. Now. 0:03:06.680 --> 0:03:09.480 This is on a background to spending twenty four years 0:03:09.520 --> 0:03:12.639 introducing screening from the moment, it was from the first 0:03:12.680 --> 0:03:15.960 report saying that there would be a benefit, but there 0:03:15.960 --> 0:03:19.160 were issues and the benefit was small. Now twenty four 0:03:19.240 --> 0:03:21.960 years later we have got national screening for bow cancer, 0:03:22.120 --> 0:03:24.560 but it's from those from sixty to seventy five. It 0:03:24.680 --> 0:03:28.200 involves having a two sample and analyzed and the blood 0:03:28.240 --> 0:03:31.200 shows up on it. Then you get a chloscopy and 0:03:31.280 --> 0:03:35.080 it's a very effective way of finding cancers before they 0:03:35.120 --> 0:03:38.520 become symptomatic. But the issue with bow cancer, though, is 0:03:38.560 --> 0:03:41.080 that it is in the people under fifty, which it's 0:03:41.200 --> 0:03:45.280 increasing dramatically about twenty five percent per decade for those 0:03:45.360 --> 0:03:48.840 under fifty and for Mario under fifty thirty six percent, 0:03:49.040 --> 0:03:52.680 so it's quite a substantial increase this sort of response. 0:03:52.960 --> 0:03:56.440 Keeping it to older people only that sort of misses 0:03:56.480 --> 0:03:59.160 the point that the big increases in those under fifty, 0:03:59.200 --> 0:04:00.920 and that's really where we're got to be driving the 0:04:00.960 --> 0:04:04.000 screening down. And this is what's happening elsewhere in the world. 0:04:04.240 --> 0:04:06.600 New Zealand's taken a long time to get the screening. 0:04:07.040 --> 0:04:11.000 It's a very long gestation, twenty four years to spread 0:04:11.040 --> 0:04:14.160 this program, and the fact that we're not adapting to 0:04:14.200 --> 0:04:17.600 what is a huge change which is happening with bout cancer, 0:04:17.839 --> 0:04:19.120 it really seems inadequate. 0:04:19.240 --> 0:04:22.080 Well you mentioned there, yeah, twenty four years of DeLay's, 0:04:22.160 --> 0:04:26.200 deferments and procrastination, and I note that you say it's 0:04:26.320 --> 0:04:29.280 led potentially to the avoidable deaths of. 0:04:29.440 --> 0:04:31.400 Thousands of New Zealanders. 0:04:31.640 --> 0:04:35.000 As someone who's dedicated their life to preventing this disease, 0:04:35.080 --> 0:04:37.560 like yourself, This must be incredibly frustrating. 0:04:38.120 --> 0:04:41.279 I think it's computable that we managed. This topic was 0:04:41.279 --> 0:04:44.400 discussed in the late nineties and every reason not to 0:04:44.480 --> 0:04:47.239 do it had been put up over that period, delay 0:04:47.480 --> 0:04:52.440 after delay and excuse after excuse. Finally it was introduced, 0:04:52.440 --> 0:04:55.880 and when labor exited in national came and labor made 0:04:55.880 --> 0:04:58.360 a promised to introducing labor had to a national ended 0:04:58.440 --> 0:05:01.400 up having to adapt the same that was under the 0:05:01.440 --> 0:05:04.400 Key government. And even then they managed to drag it 0:05:04.440 --> 0:05:06.760 out by just saying I will do a national program 0:05:06.800 --> 0:05:08.599 to see if it's any different than his zend. Well, 0:05:08.839 --> 0:05:11.200 my observation of bow cancer that it looks the same 0:05:11.240 --> 0:05:13.600 inside for most people where the male female brown or 0:05:13.640 --> 0:05:15.600 white or a near huntry there prom and I've operated 0:05:15.600 --> 0:05:17.400 in lots of different countries, but if you look at 0:05:17.400 --> 0:05:20.039 it over this whole period, there would be thousands of 0:05:20.040 --> 0:05:22.279 people that have now died that would have been found 0:05:22.279 --> 0:05:25.040 with screening and that would have avoided time from the 0:05:25.279 --> 0:05:27.360 bow cancer if it had been introduced earlier. 0:05:27.680 --> 0:05:32.400 Muori health organizations have criticized the government's revised National bowl 0:05:32.480 --> 0:05:36.479 screening program for increasing multi and Pacifica men's mortality rest 0:05:36.640 --> 0:05:37.440 what's going on there. 0:05:37.640 --> 0:05:40.039 Bower cancer is found at an earlier age if you 0:05:40.040 --> 0:05:43.240 look at the population of Marian Pacificame, and so it 0:05:43.279 --> 0:05:46.359 is important to drive it down for Marian Pacifica. The 0:05:46.480 --> 0:05:49.760 funding for the reduction from sixty to fifty eight, according 0:05:49.760 --> 0:05:52.640 to the minister, is coming from canceling that program and 0:05:52.720 --> 0:05:55.880 moving the funding because this is a financially neutral move 0:05:55.960 --> 0:06:00.760 what they're offering, and so canceling that doing by not 0:06:01.040 --> 0:06:04.680 duting the policy, not helping the Marian Pacifica issue, and 0:06:04.800 --> 0:06:07.680 just redirecting the money to the general population. They have 0:06:07.920 --> 0:06:09.800 argued more help more people, because of course there are 0:06:09.839 --> 0:06:12.760 more people that aren't married. There are, but it does 0:06:12.920 --> 0:06:15.960 come at a cost to a group that is already 0:06:15.960 --> 0:06:19.000 disadvantaged by a lot of issues around in society. 0:06:19.720 --> 0:06:21.200 I mean, won don't this mean that the people who 0:06:21.200 --> 0:06:24.359 are most at risk of bowel cancer are going to 0:06:24.360 --> 0:06:25.040 be left behind? 0:06:25.120 --> 0:06:28.160 Now, this will save more lives than the previous government's 0:06:28.200 --> 0:06:31.200 approach by lowering it to fifty eight for all New Zealanders. 0:06:31.200 --> 0:06:34.080 But what I can also say is we want to 0:06:34.320 --> 0:06:38.880 go further and faster as access to cholonoscopies allows us 0:06:38.920 --> 0:06:42.880 to I guess that critical will that second. 0:06:42.960 --> 0:06:44.280 I just want to put this to you though. This 0:06:44.360 --> 0:06:47.000 is on the Bell Cancer New Zealand website and any 0:06:47.040 --> 0:06:49.920 other number of experts you can name. They say that 0:06:50.240 --> 0:06:53.479 at present, just over half of bow cancer and mary 0:06:53.600 --> 0:06:56.760 presents before the age of sixty, whereas for non Mary 0:06:56.880 --> 0:07:00.240 it's sitting at about a third diagnosed before sixty. So 0:07:00.360 --> 0:07:03.360 that as mighty are getting it earlier, then shouldn't the 0:07:03.360 --> 0:07:06.560 screening The evidence that the Ministry of Health provided us 0:07:06.760 --> 0:07:09.840 and the analysis that was undertaken is that the age 0:07:09.840 --> 0:07:15.680 related incidence is the same based on across across different ethnicity. 0:07:15.480 --> 0:07:19.360 Groups, so different the different the difference here as we 0:07:19.440 --> 0:07:23.640 have lower screening rates in those communities. 0:07:24.960 --> 0:07:28.640 Well, surely introducing a blanket policy covering all races would 0:07:28.680 --> 0:07:31.440 only make sense if we had evidence to back that up. 0:07:31.480 --> 0:07:34.240 Though right, yes, and the evidence doesn't support that. The 0:07:34.280 --> 0:07:38.880 evidence suggests Marine pacifica diagnosed later iigher rate of metastic disease. 0:07:39.040 --> 0:07:41.400 They present at a younger age and they do worse 0:07:41.760 --> 0:07:42.600 any way we look at it. 0:07:52.760 --> 0:07:55.840 I see that you have conducted research and found that 0:07:55.880 --> 0:08:01.080 there's been a significant increase in cholorectal can diagnoses among 0:08:01.080 --> 0:08:03.760 people under fifty in New Zealand, and I see further 0:08:03.800 --> 0:08:06.960 studies in Sweden and Scotland have revealed similar trends. 0:08:07.280 --> 0:08:09.440 Tell me about this, what are some of those theories. 0:08:09.920 --> 0:08:13.680 Our cancer in New Zealand overall is actually decreasing, particularly 0:08:13.680 --> 0:08:17.760 amongst the group page fifty to eighty, the people over eighty. 0:08:17.840 --> 0:08:20.400 In New Zealand it is pretty much stable incident and 0:08:20.560 --> 0:08:23.760 those under fifty it is increasing as described before, but 0:08:23.960 --> 0:08:27.800 overall nationally it's decreasing. In Scotland it's very stable rate 0:08:27.840 --> 0:08:30.680 in bow cancer, it's not decreasing, increasing and staying the same. 0:08:30.840 --> 0:08:34.120 But we find the same observation about the rapid increase 0:08:34.280 --> 0:08:37.920 in those under fifty. In Sweden. Overall it has an 0:08:38.000 --> 0:08:40.560 increasing rate of bow cancer, and this is partly due 0:08:40.559 --> 0:08:43.199 to some of the lifestyles that people wanting to adapt, 0:08:43.400 --> 0:08:47.040 eating habits and behavior of previous generations looking back saying 0:08:47.080 --> 0:08:49.560 well we used to eat more meat, et cetera, and 0:08:49.720 --> 0:08:52.680 so they've gone in that direction. So nationally they've got 0:08:52.720 --> 0:08:55.920 an increasing rate, but the increase in those under fifty 0:08:56.240 --> 0:08:58.680 is exactly the same as in Scotland and New Zealand. 0:08:58.840 --> 0:09:01.880 So those three trees New Zealand, Scotland and Sweden all 0:09:01.920 --> 0:09:06.760 have different rates over the national total population is on decreasing, 0:09:06.920 --> 0:09:10.640 Scotland the same, Sweden increasing, and those under fifty the 0:09:10.760 --> 0:09:14.760 increase is exactly the same. So something's happening outside of 0:09:15.240 --> 0:09:18.840 something universally happening to young people, which is most likely 0:09:18.840 --> 0:09:21.840 an environmental thing, because there's no change in genes that 0:09:22.040 --> 0:09:26.200 is altering. So some behavioral thing, some adaption, that something 0:09:26.280 --> 0:09:29.240 that's going on is altering. And that here is huge 0:09:29.240 --> 0:09:32.199 implications because this increase we're seeing in young people is 0:09:32.240 --> 0:09:35.400 actually accelerating. If we break it into smaller intervals, we 0:09:35.440 --> 0:09:37.960 can see the acceleration and in fact it goes back. 0:09:38.000 --> 0:09:40.120 If we look back to the nineteen sixties, you can 0:09:40.160 --> 0:09:43.839 see the trend starting there. So something is altered. Now. 0:09:43.840 --> 0:09:46.680 There are a lot of possibilities that you know, dice change. 0:09:46.840 --> 0:09:49.480 People have more processed food, but a lot of things 0:09:49.480 --> 0:09:52.320 that we consider respects for what we call late on 0:09:52.320 --> 0:09:55.880 set normal bow cancer. For addic bow cancer is not 0:09:55.960 --> 0:09:58.600 seen in those young people, so we consider red meat, 0:09:58.640 --> 0:10:01.920 we consider smoking, We can se alcohol, lack of exercise, 0:10:02.000 --> 0:10:06.200 all issues for a beast, all issues for bow cancer 0:10:06.360 --> 0:10:10.000 and normal sporadic laid on set bowl cancer. But in 0:10:10.040 --> 0:10:13.000 young people, we know that they drink less alcohol, they 0:10:13.000 --> 0:10:15.800 smoke these cigarettes, they eat less red meat, yet they've 0:10:15.800 --> 0:10:18.800 got this big incry. So the normal whatever the normal 0:10:18.880 --> 0:10:22.840 driver is for, is not them that's doing it, and 0:10:22.960 --> 0:10:26.040 so we've got to start to think beyond that. We 0:10:26.160 --> 0:10:29.440 believe that sporadic bow cancer. So most bow cancer is sporadic. 0:10:29.480 --> 0:10:32.120 So it's just it just happens. It happens for a reason, obviously, 0:10:32.160 --> 0:10:36.000 but it's different from the people that inherit gene abnimalities 0:10:36.080 --> 0:10:39.240 or those people that have chronic infamatory conditions like colitis. 0:10:39.520 --> 0:10:42.280 Outside of that, probably eighty five percent of bow cancer 0:10:42.320 --> 0:10:45.760 at least is sporadic. It happens. That probably happens because 0:10:45.800 --> 0:10:49.080 of what you eat and the bacteria interacting in your 0:10:49.280 --> 0:10:52.679 response to that. Your bowler is lined with a protective 0:10:52.800 --> 0:10:55.360 lack of mucus. It's like a big condom that goes 0:10:55.360 --> 0:10:57.439 through your colon and protects what goes on in the 0:10:57.480 --> 0:11:00.720 middle from affecting their lining. Of about something altering. We 0:11:00.800 --> 0:11:04.360 know that the toxins made by certain bacteria, such as 0:11:04.480 --> 0:11:09.560 ZTB from PAS positive E Coli, will cause a displeasure 0:11:09.600 --> 0:11:12.760 in your colon cause pre cancer's lesions, and we've established that. 0:11:13.040 --> 0:11:16.200 We know that the normal risk factors such as red 0:11:16.240 --> 0:11:19.360 meat will make the bacteria more virulent, make them to 0:11:19.400 --> 0:11:22.520 make more toxins that we've established as well. We also 0:11:22.600 --> 0:11:25.360 know the protective things like having fireberg reen vestables will 0:11:25.360 --> 0:11:29.040 turn the toxin reduction down. So we think something's altering 0:11:29.080 --> 0:11:31.600 that model in young people. What that is, we don't know. 0:11:31.880 --> 0:11:35.280 There are many possibilities, including things like microplastics, which might 0:11:35.400 --> 0:11:40.360 well be not causing the damage themselves, not causing cancer itself, 0:11:40.400 --> 0:11:43.960 but becoming a disruptive component to altering that balance in 0:11:44.000 --> 0:11:47.439 some way, perhaps altering the muclos or protection layer. But 0:11:47.679 --> 0:11:50.520 that's where the stall where we're still researching. 0:11:54.400 --> 0:11:57.880 We've seen, just looking at the numbers, the steepest rises 0:11:58.000 --> 0:12:01.720 in early bowel cancer incidents with and in Chile, New Zealand, 0:12:01.760 --> 0:12:05.360 Puerto Rico and in England. Tell me a little bit 0:12:05.440 --> 0:12:09.000 about what kind of an impact colon cancer bow cancer 0:12:09.000 --> 0:12:10.280 diagnosis has on someone. 0:12:10.480 --> 0:12:11.080 I mean, bow. 0:12:11.000 --> 0:12:13.760 Cancer is one of the most common types of cancer, 0:12:14.240 --> 0:12:16.760 but what's important to note here is that it's still 0:12:16.800 --> 0:12:19.880 not a common disease in younger people, so only around 0:12:19.880 --> 0:12:23.719 one in twenty vow cancer cases are in younger adults now. 0:12:23.760 --> 0:12:26.760 Of course, whatever age you are, a cancer diagnosis, it's 0:12:26.840 --> 0:12:29.920 hugely impactful and that's where research is critical. We need 0:12:29.960 --> 0:12:32.400 to go further and faster when it comes to bow cancer. 0:12:33.240 --> 0:12:38.640 When it comes to bell cancer screening, how important is 0:12:38.679 --> 0:12:40.280 it to get in early. 0:12:40.400 --> 0:12:43.520 The earlier your cancers found, the bit of you're outcome 0:12:43.600 --> 0:12:46.240 to the lower the stage. So it is very important. 0:12:46.320 --> 0:12:50.160 Particularly there are a lot of focus of bell cancer screening. 0:12:50.360 --> 0:12:53.280 Awareness is about focusing on finding cancers. It's bitter to 0:12:53.360 --> 0:12:56.760 find the lesion before cancer, a pre cancerus leason and 0:12:56.800 --> 0:13:00.240 therefore you never get cancer, and therefore it's very in 0:13:00.320 --> 0:13:02.080 cheap the treat You just need the colonost to be 0:13:02.120 --> 0:13:07.520 removed the polyp and that's so it's about driving the 0:13:07.720 --> 0:13:10.640 diagnosis of the disease as early as possible. 0:13:11.000 --> 0:13:13.960 Something I was wondering before while while you were talking, 0:13:14.600 --> 0:13:17.600 if you do have one of those lesions, would you 0:13:17.720 --> 0:13:18.320 know about it? 0:13:18.360 --> 0:13:20.640 Would you see symptoms to prompt you? 0:13:20.720 --> 0:13:22.720 If you were younger than fifty and you're not getting 0:13:22.760 --> 0:13:25.920 these regular screenings, is there something that would prompt you 0:13:26.000 --> 0:13:27.200 to go get checked out? 0:13:27.440 --> 0:13:30.320 So the symptoms that should prompt you to get checked out. 0:13:30.400 --> 0:13:33.000 Are rectal bleeding, a blood in your store or on 0:13:33.040 --> 0:13:35.440 the toilet paper, a change in your bow habit, and 0:13:35.440 --> 0:13:38.400 this may be a change in frequency or consistency of store, 0:13:38.559 --> 0:13:41.080 or the feeling that you're not quite emptying outright. These 0:13:41.120 --> 0:13:44.840 symptoms are often sort of a bit sort of tidle. 0:13:44.920 --> 0:13:46.360 You might get them for a little while, then they 0:13:46.360 --> 0:13:48.480 go away and you think, oh, that's great, I forget 0:13:48.480 --> 0:13:50.320 about it. And then they come back and you think, oh, 0:13:50.400 --> 0:13:52.400 last time they went away, and sure enough they will 0:13:52.400 --> 0:13:54.720 go away, then they'll come back. But all the time 0:13:55.200 --> 0:13:59.400 this is gradually creeping up and the cancer or whatever's 0:13:59.400 --> 0:14:02.920 causing it skin worse. The difficulty of these symptoms are 0:14:03.040 --> 0:14:05.640 very common in the community, and the younger you are, 0:14:06.280 --> 0:14:08.720 the more likely there is a benign cause for this 0:14:09.679 --> 0:14:12.960 non cancerous cause. So we know at the present time 0:14:13.040 --> 0:14:16.560 that by the time people young people under fifty percent 0:14:16.920 --> 0:14:20.520 about cancer, thirty six percent of them have got metastatic disease. 0:14:20.560 --> 0:14:23.960 Disease that is stage four. It's about trying to get 0:14:24.000 --> 0:14:28.920 that driving it down to this curable just investigating symptoms, 0:14:28.680 --> 0:14:29.760 it's we've missed the boat. 0:14:30.960 --> 0:14:34.200 So if you do go and investigate the symptoms you 0:14:34.280 --> 0:14:35.600 it's likely too late. 0:14:36.040 --> 0:14:39.200 Often thirty fix percent of the time the disease has 0:14:39.240 --> 0:14:42.840 already spread. It's not to say that the symptoms shouldn't 0:14:42.840 --> 0:14:46.280 be investigated, and they should be obviously, but the length 0:14:46.320 --> 0:14:48.960 of time it takes someone from the onset of symptoms 0:14:49.000 --> 0:14:54.360 to be diagnosed and under fifty is dramatically longer than then. 0:14:54.440 --> 0:14:56.800 It is nine times longer than it is for person 0:14:56.840 --> 0:15:00.800 who's over fifty, and that's partly the biggest actually with 0:15:00.920 --> 0:15:04.040 the patient realizing that this is not going to go away. 0:15:04.640 --> 0:15:07.160 The second lot is actually getting the doctors to do something. 0:15:07.480 --> 0:15:09.760 When you front up at forty and you've got rector bleeding, 0:15:09.760 --> 0:15:11.880 a bit of a change and power habit almost always 0:15:12.000 --> 0:15:14.600 t People will think it's probably due to the hemoids. 0:15:14.640 --> 0:15:17.000 It probably often is, but it may take two or 0:15:17.040 --> 0:15:19.080 three visits in order to initiate. And then the public 0:15:19.120 --> 0:15:22.000 system is focused on older people, so you often will 0:15:22.000 --> 0:15:25.480 get the client investigation and then if they in the 0:15:25.520 --> 0:15:28.000 can to be reason at least the Canterbury Charity Hospital 0:15:28.560 --> 0:15:31.920 will scope you and then you can get a diagnosis. 0:15:31.960 --> 0:15:35.680 But it is difficult to get investigated, difficult for patients 0:15:36.400 --> 0:15:38.720 for young people to realize that symptoms aren't no more. 0:15:38.920 --> 0:15:42.120 If you could waive a magic wand Frank, what would 0:15:42.120 --> 0:15:44.080 you like to see happen tomorrow? 0:15:44.480 --> 0:15:47.000 I'd like the government to actually reduce the age of 0:15:47.000 --> 0:15:50.240 screening the forty five and make it possible for people 0:15:50.320 --> 0:15:53.080 to have it from forty That would be fantastic. I 0:15:53.080 --> 0:15:55.480 think even just doing what they promised would be nice, 0:15:55.680 --> 0:15:57.040 reducing it to the age of fifty. 0:15:57.320 --> 0:15:58.880 How likely do you think that's going to happen? 0:15:59.000 --> 0:16:01.440 Probably unlikely. There been a lot of promises and non 0:16:01.480 --> 0:16:04.640 delivery in this I don't see this government, and as 0:16:04.720 --> 0:16:08.520 you probably well aware, governments make lots of promises which 0:16:08.520 --> 0:16:09.360 they don't deliver on. 0:16:09.640 --> 0:16:10.840 Thanks for joining us, Frank. 0:16:13.360 --> 0:16:16.160 That's it for this episode of the Front Page. You 0:16:16.200 --> 0:16:19.680 can read more about today's stories and extensive news coverage 0:16:19.680 --> 0:16:23.280 at enzed Herald dot co dot nz. Subscribe to The 0:16:23.280 --> 0:16:26.480 Front Page on iHeartRadio or wherever you get your podcasts, 0:16:26.800 --> 0:16:30.160 and tune in tomorrow for another look behind the headlines.