A major study into bowel cancer has highlighted worrying gaps in detection and treatment.
The research, funded by the Ministry of Health and the Health Research Council of New Zealand, found 30 percent of patients only discovered they had the disease when they turned up at hospital, suffering severe symptoms.
Fewer than half of those with advanced cancer received chemotherapy.
Lead author Dr Christopher Jackson says the results show there's a lot more work to do.
"There needs to be more awareness of bowel cancer symptoms, doctors need to have better access to the diagnostic tests, and certainly bowel cancer screening tests would make a big improvement in the numbers of people presenting at such a late stage."
Twelve-hundred New Zealanders die from bowel cancer each year, one of the highest rates in the developed world.
"I think it's entirely acceptable in social circumstances to talk about breast lumps and PSAs, but people feel a lot more uncomfortable talking about their poos," says Dr Jackson.
"We really do need to be much more comfortable talking about bowel cancer, otherwise we're going to continue to have one of the world's highest death rates from it."
The results have led to calls for a pilot screening programme that's underway in Waitemata to be rolled out nationwide.