Bowel cancer campaigners have hailed the Government's announcement of a "potential" start date, early in 2017, for building a national screening programme to detect and treat the disease.
But they also assert that because the life-saving capacity of screening is well established, a national programme should have been created long ago and that lives are being lost without one.
Health Minister Jonathan Coleman indicated that the beginnings of a national programme could be in place from early 2017.
"I expect to take a business case to cabinet by the end of the year which will consider a potential staged roll out of a national bowel screening programme from 2017," Dr Coleman said.
A round of consultation will come first, however.
"To inform the next steps towards a possible roll out of a national ... programme, the Ministry of Health will be consulting with the health sector and other agencies on how the service could be provided across the DHBs [district health boards]."
It is the first concrete commitment from the Government to establishing a national bowel screening programme.
Previously Dr Coleman and his predecessor Tony Ryall have said that it is inevitable New Zealand will eventually have a national programme but have refrained from stating a timeframe for a scheme expected to cost $40 million to $60 million a year.
Organised screening programmes overseas have been shown to reduce bowel cancer mortality.
New Zealand has one of the developed world's highest rates of bowel cancer registration and deaths.
Around 3000 cases are registered each year and there are about 1200 deaths from the disease. Bowel cancer is our most commonly registered cancer and our second most common cause of cancer death. Survival rates are better for patients in whom the disease is detected at an early stage.
A pilot screening programme is running in the Waitemata health district for people aged 50 to 74. It began in late-2011 and was to run until December this year, but in the Budget in May, the Government granted the Waitemata DHB $12.4 million to extend the scheme until December 2017.
The scheme involves people taking a tiny poo samples at home and sending in a special container to a laboratory for detection of blood that might indicate cancer or pre-cancer. Those who have a positive result are offered colonoscopy for diagnosis.
Bowel Cancer New Zealand chairwoman Mary Bradley said of Dr Coleman's announcement: "We are really pleased that this is happening and that they are talking about a staged roll-out, but we would like to see potential moved to definite roll-out in 2017."
"We would like to see a staged roll out now or a start next year would be fantastic. We've always known it [screening] is proven, so why wasn't it done sooner. It could have happened a couple of years ago. This is great, but it's taken a long time to get here. In the meantime, people are dying."
Dr Coleman said the main constraint on creating a national programme would be having enough colonoscopy staff. Schemes were under way to address this, including extra colonoscopy funding for DHBs, and increasing the number of doctors training as gastroenterologists, one of several groups of health workers who can do colonoscopies.
"The sector is also considering increasing the use of CT colonography [specialised x-rays] where appropriate."