New guidelines released by Cancer Care Ontario indicate that the province is reducing the screening age for colorectal cancer from 50 to 45 due to a significant increase in younger individuals being diagnosed with the disease. A document from Ontario Health detailing the new recommendation specifies that the change will be effective starting July 1. Prince Edward Island was the first province in Canada to implement this lower screening age back in March. Advocacy groups like Colorectal Cancer Canada and the Canadian Cancer Society have been advocating for all provinces and territories to make this adjustment, pointing to data showing that individuals under 50 have a higher risk of colorectal cancer compared to previous generations.
Following the lead of the United States and Australia, Ontario’s decision to lower the screening age is supported by expert panel advice, the rise in early-onset colorectal cancer cases in the province, and statistical models demonstrating that earlier screening can decrease the incidence and mortality rates of the disease. The Ministry of Health in Ontario stated that these program modifications will enhance the detection and treatment of cancer at earlier stages, building on the province’s previous initiative to lower the breast cancer screening age from 50 to 40 two years ago.
A routine colorectal screening involves a fecal immunochemical test (FIT), where individuals collect stool samples at home for testing. If the test indicates the presence of blood in the stool, a colonoscopy is recommended to check for cancer. The government plans to send out screening invitation letters gradually, and after July, doctors can order the FIT for individuals aged 45 to 49. Additionally, the recommended age for colonoscopies will be lowered for individuals with a first-degree relative who was diagnosed with colorectal cancer before the age of 60.
Individuals falling into this high-risk group will commence screening at 40, or 10 years earlier than the age of their youngest affected relative, with screening intervals every five years. Those with one older relative diagnosed with colorectal cancer at 60 or older will undergo FIT screening every two years from the age of 45. This change is supported by evidence indicating similar risks of developing colorectal cancer between this group and the general population, aiming to expedite colonoscopy access for those with abnormal screening results.
Health providers are advised to anticipate a slight increase in abnormal test results as more people undergo screening. The government foresees a surge in demand for colorectal cancer surgeries and pathology specimens initially but expects these volumes to stabilize over time as pre-cancers are identified and treated. The president and CEO of Colorectal Cancer Canada, Barry Stein, hailed Ontario’s decision to lower the screening age to 45 as a significant advancement and called for all other provinces and territories to adopt similar measures.
In Ontario, the drop-off locations for completed FIT kits are being updated, with patients now able to leave them at any Rexall location or mail them to In-Common Laboratories.
