Embarrassment can't kill, yet it stops us getting tested for a cancer that can. Gary Hamilton-Irvine explains.
Among New Zealanders' greatest enemies the "silent killer", bowel cancer, is among the worst.
Bowel cancer takes the lives of 1200 New Zealanders every year and is the second biggest cancer killer in the country, behind lung cancer.
Its symptoms are embarrassing for most people, giving the Ministry of Health, general practitioners and past sufferers a headache when they try to make people more comfortably aware about getting checked.
Beat Bowel Cancer Aotearoa chairwoman, Rachel Holdaway, was a fit athlete when bowel cancer struck.
"I was 41, I was training for a duathlon and you're supposed to feel good, but I just felt worse and worse," she says.
"I found 1km into my runs I urgently needed to go to the toilet, and I had a little bit of rectal bleeding as well. I just put it all down to other things like haemorrhoids and training hard."
She says she had a blood test, only to learn her iron levels were well down.
"So I went to my GP and by this stage my bowel habits had changed as well."
Her general practitioner said it would be best to undergo a colonoscopy and it was revealed she did indeed have bowel cancer.
Only four months passed between Holdaway's first symptoms and when the cancer was removed, making her one of the lucky ones. "The good news is if you catch it in the early stages it is one of the more curable cancers."
Holdaway says the symptoms include blood in your faeces and a persistent change in bowel movements, including increased constipation or pain in the abdominal area.
"It is embarrassing, but your body has to be in working condition and people need to feel comfortable talking about that. People freely talk about heart problems, and there is no difference," she says.
"It actually kills more New Zealanders than prostate and breast cancer combined; it is our silent killer."
She says New Zealand has one of the worst rates in the world for bowel cancer deaths, partly because a screening programme is still only in its early years in this country.
"New Zealand is 10 years behind other developed countries in establishing a national screening programme for bowel cancer."
The Ministry of Health has funded a bowel cancer screening pilot programme in Auckland's Waitemata district, with a focus on boosting checks across the country if it is successful.
Waitemata District Health Board communications manager Eric Atwood says the four-year programme began last November. Five people screened on it have been treated for the cancer as a result.
"This screening programme will help save lives."
He says screening includes giving people privacy by giving them test kits to use at home.
About 70,000 Waitemata people were sent the kits, which included a test container in which they could send back a sample of poo, in a secure envelope, to the testing lab for a positive or negative match.
"If it is positive - so there is blood found in the [poo] sample - we send back another letter requesting they come in for further testing and a colonoscopy."
He says the model had been tested and proved successful in the US, Britain and Australia.
General Practice New Zealand executive member Des Epp says the promoting of health checks in the media, such as John Kirwan's depression ads, had definitely improved New Zealanders' mindset for getting checked.
"It's becoming more acceptable to come in and see your GP and say, 'Hey, I'm a bit down or I'm not feeling right'."
He says you should not be embarrassed about undergoing a check for bowel cancer and he would rather someone came in 50 times and not have the disease than not come in at all and their symptoms be missed.
Ninety per cent of bowel cancer shows up in people over 50 years of age and the recommendation is to be screened every two years from that age.
More care should be taken at a younger age by people whose families have a history of bowel cancer.