Ontario is the second province in Canada to lower the routine colorectal cancer screening age from age 50 to 45.
As of July 1, Ontarians age 45 and up are eligible to receive the at-home fecal immunochemical screening test—or FIT—that detects traces of blood in the stool.
If someone has an abnormal result, they can be referred for a colonoscopy.
Prince Edward Island was the first province to lower the screening age last March.
Colorectal Cancer Canada president Barry Stein says colorectal cancer is on the rise among younger adults and can be prevented if polyps in the colon or rectum are detected early and removed.
Both Stein and the Canadian Cancer Society are urging the other provinces and territories to follow P.E.I.’s and Ontario’s lead, saying that the change will save lives as well as health-care costs.
“We should all be able to have the same advantages to prevent the disease, regardless of the province or territory that you live in,” said Stein, who endured multiple surgeries after being diagnosed with colorectal cancer at age 41 in the 1990s.
According to Cancer Care Ontario, nine out of every 10 people can be cured when colorectal cancer is detected early.
Stein said all the provinces are at various stages of looking at the numbers and considering the change for people with an average risk of colorectal cancer.
The other provinces currently recommend FIT screening for people between age 50 and 74.
People who are at above-average risk of colorectal cancer generally get specialized screening, regardless of what province or territory they live in.
Someone is considered at higher risk if one parent, sibling or child had colorectal cancer before age 60 or if two family members had it at any age.
People at higher risk get colonoscopies rather than FIT screening and they can start them at age 40—or 10 years earlier than the age their family member was diagnosed—whichever is earliest.
People with existing symptoms of possible colon cancer, including blood in the stool, bleeding from the rectum, changes in bowel habits or anemia should not do a FIT test but instead should see a health-care provider to assess whether a colonoscopy or other diagnostic test is needed.
Trish Riley was shocked when a colonoscopy triggered by unexplained blood loss revealed she had stage 3 colorectal cancer at age 51.
“My first question that came out of my mouth was, ‘Am I going to die?’ It’s a reality that you’re hit with very quickly in those first few hours, weeks and months,” said Riley, now 55, who lives in Ottawa.
She went through surgery to remove the tumour, followed by months of gruelling chemotherapy because the cancer had spread to four lymph nodes.
Because it usually takes about 10 years for a benign polyp to turn cancerous, Riley wonders if she could have been diagnosed at an earlier stage if testing had been available when she was 45.
She strongly believes in early detection even though she had a false negative FIT screening just months before her cancer diagnosis.
The Canadian Cancer Society said in an email to The Canadian Press on Tuesday that no screening test is 100 percent accurate, but “the scientific evidence tells us that having regular FIT or stool tests with appropriate followup lowers the risk of dying from colorectal cancer.”
“When you think about how important it is to find cancer early, the Canadian Cancer Society believes the benefits of having regular stool tests for colorectal cancer outweigh the limitations,” said Elizabeth Holmes, the society’s director of health policy.
Riley, whose CT scans over the last few years have shown no cancer, said she was “super proud” of P.E.I. when it announced it was lowering the age for FIT screening to age 45 and was “thrilled” that Ontario is doing the same.
She said she feels sad for people in other provinces who may not have their cancers detected early enough.
“My heart goes out to the people who will be diagnosed at a stage where it’s possibly too late to really end up with a result such as mine, or just that they will go through some treatments that possibly they might have avoided had it been detected at an earlier stage.”
