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Colorectal Cancer Screening Program

Cancer Care Ontario: Colorectal Screening Program

The colorectal cancer screening program aims to save lives by having more people 50 years of age and older screened for colorectal cancer. Those who are at increased risk because of a family history (one or more first degree relatives with colorectal cancer) or with a positive Fecal Occult Blood test (FOBT) test should receive a colonoscopy.

Remember, only patients who have one or more first degree relatives with a family history of colorectal cancer or those with a positive FOBT are eligible for this program.

If you have any questions or comments, can visit www.cancercareontario.ca send an email to colorectalcancerscreening@cancercare.on.ca or call 1-866-662-9233.

More Information for Family Physicians:

Frequently Asked Questions

Can you provide an overview on Ontario's Colorectal Cancer Screening Program?
On January 23, 2007, the Ontario Ministry of Health and Long-Term Care and Cancer Care Ontario announced this five-year, $193.5-million program, the first of its kind in Canada. This organized, province-wide population-based program aims to save lives by having more people screened earlier. The target population is Ontario men and women, 50 years of age and older. Those who are at increased risk because of a family history of one or more first degree relatives with colorectal cancer should be screened by colonoscopy. Those who are at average risk should be screened every two years using an easy-to-use home screening test called the fecal occult blood test (FOBT). During 2008/2009, there will be increased access to screening through a wide distribution of branded FOBT kits to family physicians, other primary care sites, and for people without a family physician, through pharmacies and Telehealth Ontario.

What are the objectives of the Colorectal Cancer Screening Program?
The program, to be rolled out over five years, is designed to increase screening rates and decrease colorectal cancer-related deaths in Ontario and primarily targets men and women, 50 years and older.

What is colorectal cancer?
Colorectal cancer is the second most common cause of cancer deaths in North America. Most cases occur in persons over the age of 50 who do not have special risks for colon cancer. It is typically a slow growing cancer and therefore screening programs are particularly effective. Current information demonstrates that fewer than 20 per cent of men and women 50 years and older (screen eligible age group) are screened by any method.

Who should be screened for colorectal cancer?
All men and women 50 years of age and older should undergo screening for colorectal cancer. Guidelines recommend that individuals at average risk (individuals aged 50 or over who have no family history of colorectal cancer or any symptoms) should undergo screening with either fecal occult blood testing (FOBT) or flexible sigmoidoscopy as part of the periodic health exam (Canadian Task Force on Preventive Health Care, 2001).

Individuals who have a positive FOBT, or are at increased risk because of a family history of colorectal cancer (one or more first degree relatives with colorectal cancer), or with an abnormality detected at flexible sigmoidoscopy, should be referred for colonoscopy. For those at increased risk because of family history, screening should begin 10 years prior to the date of diagnosis of their first degree relative. For example, if the first degree relative was diagnosed at 55, then the individual should begin screening at 45.

What is a first degree relative?
First degree relatives include biological mother, biological father, biological sister, biological brother, biological daughter or biological son. It does not include extended family members (eg: aunt, uncle, grandparents, in-laws etc.).

What is a Fecal Occult Blood Test (FOBT)?
The FOBT is a simple test used for colorectal cancer screening that is completed at home and requires the collection of three stool specimens. The test can detect invisible amounts of blood in the stool.

What is a colonoscopy?
A colonoscopy is a cancer screening test that provides early detection of colorectal cancer by using a soft, bendable, lighted tube which is inserted into the rectum. The rectum and entire colon are examined, and if necessary, biopsies are taken and polyps removed. This test is usually performed under light sedation, in a special endoscopy suite at a hospital, by a physician. A person must "prepare" their colon for examination by taking laxatives the day prior to the exam. A colonoscopy is used as the recommended follow-up test for an individual with a positive FOBT.

Who will deliver the program, and how?
Beginning in 2008, information and FOBT kits will be available through family physicians (FP). For those people who don't have FPs, kits will be available through pharmacies and through Telehealth Ontario.

For average risk Ontarians (i.e., those 50 years and older with no large bowel symptoms), the Fecal Occult Blood Test (FOBT) will be the primary screening tool. Colonoscopies will be used to screen people who are deemed to be at increased risk because they have a family history of colorectal cancer, defined as one or more first degree relatives - parent, sibling or child - with a history of colorectal cancer

Do I need a referral to see a specialist for a colonoscopy?
Yes, OHIP regulations state that referrals are required to see a specialist unless the visit is a follow up. 

How do I find a family physician?
Quinte Health Care has a hotline that is updated with family physicians who are accepting new patients. This number is 613-969-7400, extension 7600. 

If you are unable to find a family physician accepting patients, you will be required to visit a walk-in clinic to obtain a referral.

How do I obtain more information about the Colorectal Cancer Screening Program?
Cancer Care Ontario and the Ministry of Health and Long-Term Care will post information on new program developments on www.cancercare.on.ca and www.health.gov.on.ca.