Screening for colorectal cancer and prostate cancer: challenges for New Zealand

Aim Prostate cancer and colorectal cancer are the most commonly registered cancers in New Zealanders and among the five most commonly registered cancers worldwide, but the balance of benefits and harms, and therefore appropriate screening policies, for these cancers differ. We aimed to compare the potential benefits and harms of screening for prostate cancer and colorectal cancer to aid prioritisation in New Zealand. Method Relevant reports from randomised controlled trials and systematic reviews of prostate cancer and colorectal cancer screening were reviewed to obtain estimates of the potential benefits and harms of screening for prostate cancer and colorectal cancer. Results The balance of potential benefits and harms of screening is better for colorectal cancer screening than for prostate cancer screening. For colorectal cancer, the balance of benefits and harms is better for flexible sigmoidoscopy screening than for faecal occult blood screening. Conclusion In New Zealand, colorectal cancer screening should be a priority. Challenges include colonoscopy capacity, and decisions about the most appropriate screening modality.