Screening tests help find colon cancer (also known as colorectal cancer) before any symptoms develop. Screening means checking or testing for disease in a group of people who don’t show any symptoms of the disease.
If you are 50-74 years old, get screened for colon cancer every 2 years.
Colon cancer is 90% curable when caught early!
The Canadian Cancer Society recommends that ALL people living in Ontario ages 50-74 be screened for colon cancer regardless of sexual or gender identity.
Some people may need to get screened earlier or more frequently depending on their risk factors.
|Average risk, 50-74 years old||Fecal Occult Blood Test (FOBT) at least every two years|
|High risk (first degree relative with colon cancer)||Colonoscopies starting at age 50 or 10 years before age of diagnosed relative|
|Other high risk people||Talk to your doctor about screening|
People who are at higher than average risk of developing colon cancer may need to be tested more often and at an earlier age than people with average risk. Some factors that could put you at higher than average risk include:
How can you tell if you’re at increased risk? Know your risk factors and talk to your healthcare provider or call Telehealth Ontario at 1-866-797-0000 or TTY: 1-866-797-0007 and speak to a nurse about conducting a risk assessment.
In Ontario, the method of finding colon cancer early is testing the stool for occult (hidden) blood. The fecal occult blood test (FOBT) is recommended every two years for people ages 50 and over. The FOBT is non-invasive and can be done at home.What is the FOBT?
The Fecal Occult Blood Test (FOBT) is the recommended screening test for colon cancer for adults age 50 and over at average risk. It’s safe, non-invasive and recommended every two years. You use the FOBT at home to test your stool (bowel movements).
The FOBT checks for occult, or hidden, blood in the stool. Polyps and/or tumours in the colon have blood vessels that can release a small amount of blood onto the stool. Although this blood isn’t often visible, the FOBT can detect it. By finding occult blood, the FOBT helps identify polyps often before they become cancerous.
If the FOBT finds blood, it doesn’t necessarily mean that you have cancer. If the test finds blood, you’ll need more testing to find out its cause.
The FOBT checks for traces of blood in the stool from polyps or tumours. Traces of blood can be present in the stool for a variety of reasons, not just cancer.
The FOBT comes in a paper kit with simple instructions. The test involves taking three small, separate stool samples over three different days, at home. Each sample is smeared onto a paper card. You then mail the kit to a lab for analysis. If there’s blood in the stool, a chemical reaction on the paper card will alert lab technicians.
It’s natural to be uncomfortable doing a test that involves handling your own stool. It can help to remember that this simple test can help save your life.
FOBT kits are free of charge. You can get an FOBT kit in the following ways:
Taking a stool test for colon cancer is simple. But make sure to take a few minutes to read all of the instructions provided in the instructional kit before you take the test. You can also download a PDF copy of the instructions.
You’ll be asked to collect stool samples on three separate days. However, you should avoid collecting samples if blood is visible in your stool or urine. For instance, it’s not a good time to do a stool test if hemorrhoids are bleeding.
Be sure to avoid citrus three days before the test as well as during the test. This includes vitamin C supplements, citrus juices and fruit, such as oranges and grapefruit. Except for citrus, you can eat your regular meals and take your prescribed medications.
Once you have the free kit, the test is pretty easy.
You will collect stool samples on three different days from three different bowel movements within a 10-day period. This means that, once you begin the test, you have to finish it within 10 days of starting. The kit comes with applicator sticks, a test card, a foil envelope, a requisition form, and a pre-paid postage envelope.
The test card has three different flaps, one for each day. Under each flap, there are two separate areas on which to smear your samples.
To collect the stool you can use a disposable container, plastic wrap or several layers of toilet paper in the toilet bowl to support the stool. You then use the applicator stick to collect a small sample of the stool. You apply a very thin smear to area 1 of the flap. You then smear a second sample from a different part of the stool in area 2 of the flap. Wait until the samples are dry before you close the flap.
Collect your next samples during your next bowel movements for two more days. Place the test card in the unsealed foil envelope between bowel movements. Be sure to keep the test card in a place away from heat, light, water and chemicals.
When you’ve collected all of your samples, you can seal the envelope. The envelope is pre-addressed and the postage is paid. When you’re done, all you have to do is mail it back or drop it off at a local community laboratory collection centre.
Some helpful tips:
Check out this video to learn how to complete the FOBT in the comfort of your own home.
You can also find detailed instructions on how to complete the FOBT kit in English, French and 26 other languages at ColonCancerCheck (PDF).
ColonCancerCheck was launched in the spring of 2008 as the first population-based, organized colon screening program of its kind in Canada. The program is a partnership between the Ontario Ministry of Health and Long-Term Care and Cancer Care Ontario (CCO). CCO is a provincial government agency responsible for improving cancer services.
The goals of ColonCancerCheck are to reduce deaths from colon cancer through an organized screening program, and to support healthcare providers in providing the best possible colon cancer screening for their patients.
For more information about ColonCancerCheck:
Once the lab has processed your sample, there are several different ways you may get your results:
You can expect your test results within a month. If you haven’t received them by this time, contact your healthcare provider. If you don't have a healthcare provider, call ColonCancerCheck at 1-866-410-5853 to find out about the status of your results.
If your test results are negative, that means that the test was not able to detect blood in your stool.
If your test results are positive, this means that you have blood in your stool. Most people who have blood found in their stool do not have colon cancer. Blood can be found in the stool for many reasons including ulcers, hemorrhoids, inflammatory bowel disease, diverticulosis, or as a result of taking anti-inflammatory medications.
If you tested positive, get follow up care to determine why you have blood in your stool. Follow up care usually means having a colonoscopy within two months of the FOBT finding blood in your stool. If you don’t have a primary healthcare provider, ColonCancerCheck will refer you to a doctor or nurse practitioner for follow up care.
If your test is negative, you will be sent a reminder letter by ColonCancerCheck to repeat the test in two years.
A colonoscopy is a procedure that lets the doctor look at the lining of the entire rectum and colon. The procedure uses a small flexible camera that is inserted into the anus.
On the down side, colonoscopies are more invasive than FOBTs. On the up side, they can provide treatment as well as screening. If polyps are found during the test, they can usually be removed during the procedure. Biopsies are taken of growths that are too large to be removed and/or that appear to be cancer. These are tested for cancer and are removed surgically at a later date.
A colonoscopy is the usual follow-up test for people who have a positive FOBT result. Colonoscopies are also used as the initial screening test for people who have a higher than average risk for developing colon cancer.
A colonoscopy is done in a hospital or clinic on an outpatient basis. The procedure usually takes about 30 to 40 minutes.
To get a colonoscopy, you need a referral from your doctor. Your doctor will also give you instructions on how to prepare for your colonoscopy to make sure the procedure is safe and effective. Preparations usually include:
If you have questions about the procedure, be sure to ask them before you take the sedatives, as they can impair your ability to think clearly. Some questions you may want to ask include:
It’s true: a colonoscopy is an intimate procedure. It also requires some careful preparation, which can be uncomfortable. Here are some tips to make the prep and the procedure as comfortable as possible:
Let’s be frank: many of us aren’t thrilled about the idea of having a scope inserted into the anus. Having a colonoscopy is an intimate procedure, and the test or its preparation may have you feeling embarrassed, anxious or vulnerable. Those of us who have had negative experiences with the healthcare system or who are survivors of abuse may find the test upsetting or traumatic. Still, a colonoscopy can save your life. Here are some tips to make the process more emotionally comfortable:
If your colonoscopy finds no cancer, polyps or any other problem, you do not have to get another colonoscopy for ten years. At that point, you will go back to getting an FOBT every two years.
If your colonoscopy results are abnormal, that could be for a variety of reasons. Some include diverticulosis (abnormal pouches in the lining of the colon), inflammatory bowel disease, bleeding, polyps or cancer.
If your colonoscopy showed polyps, they were likely removed during the test. Talk to your health care provider about when you have to get screened again. If polyps can’t be removed, then further treatment will likely be required.