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Frequently Asked Questions

Please send us your questions! Email Arti Mehta at if you have any questions about colon cancer screening that isn’t covered below.

Will gender affirming hormone therapy affect my risk of colon cancer?

We don’t know if levels of testosterone, estrogen or progesterone are risk factors for colon cancer. What we do know is that health care professionals do not need to know about hormone levels for non-trans people when screening for colon cancer. For example, doctors don’t ask non-trans women if they are on birth control. Health care providers who work with trans communities have let us know that hormone changes are likely irrelevant to colon cancer risk. We can’t say this for sure because there is no evidence either way.

Is there anything about my sexual or gender identity that affects my risk of colon cancer or getting tested for colon cancer?

There is nothing about one’s sexual or gender identity that affects colon cancer risk, or what type of testing you would need. If you’re over 50, regardless of your sexual or gender identity, it’s a good idea to get checked for colon cancer.

I am experiencing some of the symptoms of colon cancer. Should I go get screened?

It’s important that you talk to a health care provider if you are experiencing symptoms of colon cancer. Cancer screening is intended for people who are not experiencing symptoms of cancer. A healthcare provider will determine the best course of action based on your personal situation.

I’m under 50 and I am not high risk for colon cancer. Since I cannot get screened, how can I take care of my colon?

It’s a good idea to be proactive about your health and take care of your colon at any age. Eating healthy, exercising, drinking less than two alcoholic drinks a day, eating less than three servings of red and processed meat a week, not smoking and avoiding second hand smoke, avoiding cooking meats at high temperatures, and increasing your vitamin D intake are all excellent ways of taking care of your colon. It’s also important to eat foods high in fibre, which acts as a protective factor against colon cancer.

Why do I sometimes hear colon cancer and sometimes I hear colorectal cancer? Are they the same thing?

Colon cancer refers to both colon and rectal cancers, which are very similar in terms of risk factors, diagnosis and prognosis. Because most people in the public refer to both as colon cancer, the Canadian Cancer Society, Ontario division has chosen to refer to both as colon cancer.

How can I get the at home stool test, the Fecal Occult Blood Test (FOBT), if I don’t have a doctor?

If you are over 50 years old and don’t have a family doctor, call Telehealth Ontario’s Colorectal Screening Line at 1-866-828-9213. A representative will conduct a risk assessment with you and mail you a kit if you are eligible.

For the FOBT do the stool samples have to be collected 24 hours apart, or is it okay if one is taken on an evening and then the next morning?

You should collect the stool samples on three different days. The samples can be taken at different times so they may be less than 24 hours apart. You may miss a day collecting your samples; however, it is important that your third sample is collected within 10 days of the first sample.

For the FOBT, what if my next bowel movement occurs during the same day that a sample has already been taken? Do I need to take the samples on different days?

The samples should be collected on different days. If you have more than one bowel movement in the same day you should wait until the next day to collect your next sample.

For the FOBT, are there times when I should not collect samples?

You should not do the test if you are experiencing any symptoms of colon cancer, including if there is blood in your stool or urine. If you have these symptoms, you should wait to do the test until you have stopped bleeding for at least three days. As well, it’s important to speak to your health care provider about any abnormal bleeding you’re experiencing.

If you have blood in your urine, or are bleeding from hemorrhoids, you should wait to do the test until you have stopped bleeding for at least three days. It’s also important to check in with your doctor about any abnormal bleeding that you’re experiencing.

I have been told that a colonoscopy is more effective than a FOBT. Is that true?

An at home stool test, also known as the Fecal Occult Blood Test (FOBT) is the recommended screening test for colon cancer for people of average risk who are 50 or over. It’s safe, non-invasive and has been identified as the best method to detect colon cancer in people who are at average risk with no symptoms of colon cancer. If you are at a higher risk of colon cancer, talk to a health care provider about which test is right for you.

I see a naturopathic doctor who takes care of my colon health. Should I still get screened?

Many LGBTQ people prefer natural and holistic ways of taking proactive care of our health. It’s wonderful to take care of your health in the ways that work for you. While there may be many natural ways that we can take care of our colon health, the most reliable method of finding colorectal cancer early for those at average risk is testing the stool for occult (hidden) blood.

Is the fecal occult blood test (FOBT) always accurate?

Colon cancer screening tests are generally very safe and have minimal risk however the FOBT isn’t perfect. There is a small chance that the FOBT will not detect blood in the stool, because a polyp may not be bleeding at the time you take the test. This is why it is important to get screened every two years from age 50 onwards.

What is the FIT screening test for colon cancer?

FIT (or iFOBT) is a newer type of FOBT that uses specific antibodies for human blood to find traces of blood in the stool. FIT is being used by some, but not all, screening programs in Canada. FIT is currently not being used in Ontario.

I’ve already had a colonoscopy to diagnose a non-cancer related issue. Does this mean I have been screened for cancer as well?

Yes. Aside from diagnosing other problems, such as Crohn’s disease, the colonoscopy will have checked for polyps that are indicative of colon cancer.

I have HIV. Should I get screened more often?

If you’re 50 and over, you need to get screened for colon cancer, regardless of your HIV status. As far as we know, HIV in and of itself does not increase risk of colon cancer. This is not true for anal cancer, which is different from colon cancer (see anal cancer FAQ). However, many people living with HIV have other risk factors for colon cancer, such as higher rates of smoking. It’s important to speak to a health care provider to find out what your risk level is.

What are adenomatous polyps, familial adenomatous polyposis and hereditary non-polyposis colon cancer?

Adenomatous polyps (adenomas) are a type of polyps that can sometimes become cancerous and takes, on average, ten years to develop into an invasive colon cancer. The incidence of adenomas increases with age.

Familial adenomatous polyposis is an uncommon inherited condition that causes hundreds to thousands of polyps to develop on the lining of the colon and/or rectum and greatly increases a person’s risk of developing colon cancer. If left untreated, almost all people with FAP will develop colon cancer. FAP accounts for 1% of colon cancers and can be identified through family history and genetic testing.

Hereditary non-polyposis colon cancer is an uncommon inherited condition that causes a large number of polyps to develop, although less than those with FAP. People with HNPCC have a 70-80% lifetime risk of developing colon cancer. HNPCC accounts for 3-5% of all colon cancers and be identified through family history and genetic testing.

For more information on these polyps, visit

What are the risks of getting a colonoscopy?

The biggest benefit of a colonoscopy is, of course, that it can find cancer, either before it starts or at its early stages, and save your life. But colonoscopies can have risks associated with them as well. Some of those side effects can include:

  • small amounts of blood in the stool for 1 2 days, if a biopsy was done or if a polyp was removed
  • nausea, vomiting, bloating or irritation due to the substances used to cleanse the colon and the air used to inflate it
  • possibly experiencing transphobia and other forms of prejudice while getting screened

Some more uncommon complications could include:

  • bowel perforation
  • heavy bleeding
  • an allergic reaction to the medication used for sedation
  • endocarditis (inflammation of the inner lining of the heart). This may occur in people with artificial heart valves, congenital heart disease
  • heart murmurs or those who have had previous episodes of endocarditis.

While it can be scary to think of these possible risks and side effects of getting a colonoscopy, it’s important to remember that the risk for the physical side effects is actually quite low.

We know that preserved meats increase the risk of some types of cancer, but what about smoked fish?

The research on smoked fish is inconsistent. We do know that smoking exposes meat or fish to the smoke of a wood or charcoal fire. The foods absorb large amounts of the tar that comes off the smoke, and these tars may contain cancer-causing compounds.

The Canadian Cancer Society recommends that I drink less than two drinks a day. Can I save up my drinks and drink them all over the weekend?

We don’t recommend that you drink more than two drinks a day even if you have not drank alcohol in the previous few days. The risk of developing cancer increases with the amount of alcohol a person drinks. For example, drinking about 3.5 drinks a day can increase the risk of developing colon and breast cancer by 1.5 times. For more information, click here.

One of the factors that increase risk is ethnic background, specifically people of Ashkenazi (Eastern European Jewish) descent. Why is that?

Jews of Eastern European descent (Ashkenazi Jews) are at increased risk of developing colon cancer because this group tends to have a specific mutation in the APC gene that increases the risk of colon cancer. This genetic mutation is not common among other ethnic groups.

Is anal cancer the same thing as colon cancer?

Anal cancer is often confused with colon cancer. Colon cancer begins when cells in the lining of the colon or rectum change and become abnormal. Abnormal cells can multiply and form small, non-cancerous growths called polyps. Anal cancer occurs in the anal canal. A different type of cell lines the anal canal and thus, it is a different type of cancer. Anal cancer spreads slower than colon cancer. Colon cancer is much more common than anal cancer. There are currently no clear guidelines on anal cancer screening for trans people in Ontario, but if anal cancer is detected and treated early, the chances of successful treatment are better.

Visit for more information on anal cancer and how to reduce your risk.

Why does Get Screened only focus on colon, breast and cervical cancers?

There is a lot of evidence supporting the effectiveness of screening for colon, breast and cervical cancers at a population level. This means that for the general population as a whole, these three screening tests have been proven to have more benefits (i.e.: save lives) than drawbacks. Screening tests exist for other types of cancers as well. As the recommendations for these screening tests are often based on your own medical and personal history, the Canadian Cancer Society would not be able to promote them to LGBTQ communities as whole. Therefore, you should speak to your doctor about the benefits and risks associated with other cancer screening tests based on you own medical and personal history. You can find more information about other types of cancers and early detection at

For more information contact our Cancer Information Service at
1 888 939 3333
TTY 1-866-786-3934