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Frequently Asked Questions

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

No. Nothing about a person’s sexual or gender identity affects colon cancer risk or testing needs. If you’re over 50, it’s a good idea to get checked for colon cancer regardless of your sexual or gender identity.

Am I able to have receptive anal sex (bottoming) when completing the Fecal Occult Blood Test (FOBT)?

Yes, you can have receptive anal sex (bottoming) when completing the FOBT. You can continue to be sexually active during the time that samples are collected for the FOBT.

I have some of the symptoms of colon cancer. Should I get screened?

It’s important that you talk to a healthcare provider if you have symptoms of colon cancer. Cancer screening is intended for people who are not experiencing symptoms of cancer. A healthcare provider will examine you and figure out the next steps.

I’m under 50 and I am not high risk for colon cancer. Since I can’t 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 no matter how old you are. You can take care of your colon by:

  • eating healthy foods and maintaining a healthy weight
  • eating foods high in fibre
  • exercising regularly
  • limiting alcohol to fewer than two standard drinks a day
  • eating fewer than three servings of red and processed meat a week
  • not smoking and avoiding secondhand smoke
  • avoiding cooking meats and fish at high temperatures
Why do I sometimes hear “colon cancer” and sometimes “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 FOBT if I don’t have a doctor or other healthcare provider?

If you’re age 50-74 years old and don’t have a family doctor or other primary healthcare provider, call Telehealth Ontario to talk to a registered nurse about getting the kit at 1-866-797-0000 or TTY 1-866-797-0007.

Do the stool samples for the FOBT have to be collected 24 hours apart, or is it okay if one is taken on an evening and another 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 fewer than 24 hours apart. You may miss a day collecting your samples, but it’s 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 your bowel movement 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 finding blood in your stool. If you are experiencing symptoms of colon cancer, it’s important that you speak to a healthcare provider.

If you have blood in your urine, or are bleeding from hemorrhoids or dental work, you should wait to do the test until you have stopped bleeding for at least three days.

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

The Fecal Occult Blood Test (FOBT) is the recommended screening test for colon cancer for people age 50-plus who are of average risk. It’s safe and non-invasive, and has been identified as the best method to detect colon cancer in this population. If you’re at a higher risk of colon cancer, talk to a healthcare provider about which test is right for you.

Is the FOBT always accurate?

Most of the time. Colon cancer screening tests are generally very safe and have minimal risk. But 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 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 your risk of developing 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 healthcare provider to figure out your risk level.

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.

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

Adenomatous polyps (adenomas) are a type of polyp that can sometimes become cancerous. Adenomas take, on average, 10 years to develop into invasive colon cancer. The incidence of adenomas increases with age.

Familial adenomatous polyposis (FAP) is an uncommon, inherited condition that causes hundreds to thousands of polyps to develop on the lining of the colon and/or rectum. This condition 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 (HNPCC) is an uncommon, inherited condition that causes many polyps to develop in the lining of the colon and/or rectum. People with HNPCC develop fewer polyps 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 can 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 also have risks associated with them. Some of those risks or 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

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 that any of these complications will occur 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. These tars may contain cancer-causing compounds.

It is often difficult to determine the risk of cancer in studies because cured and smoked foods are often salted and cured foods like bacon may also be cooked at a high temperature. All of these may be factors in increasing cancer risk.

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

Drinking more than two drinks a day — even if you have not consumed alcohol in the previous few days — is not advised. The scientific evidence related to alcohol consumption and increased cancer risk continues to grow. 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 cancer of the colon and breast by 1.5 times. For more information, click here.

One of the factors that increases 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?

No. Anal cancer is often confused with colon cancer, but they are different diseases. Colon cancer is much more common than anal 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. Over time, if these polyps aren’t treated, they can become cancerous.

Anal cancer occurs in the anal canal. A different type of cell lines the anal canal, which is why anal cancer is different than colon cancer. Anal cancer spreads more slowly than colon cancer. There are currently no clear guidelines on anal cancer screening for gay and bisexual men 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.

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

A lot of evidence supports the effectiveness of screening for colon, breast and cervical cancer 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 than drawbacks. In other words, screening for these cancers saves lives!

You can screen for other cancers, but the recommendations for these screening tests are often based on your own medical and personal history. For this reason, the Canadian Cancer Society can’t promote other cancer-screening tests to LGBTQ+ communities as whole. If you think or know that you might have a higher risk of developing other types of cancer, you should talk to your healthcare provider about the benefits and risks associated with other cancer screening tests. 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 3939 FREE
TTY 1-866-786-3934

The Cancer Information Service is a free, national, bilingual, toll-free service that provides comprehensive and credible information about cancer and community resources to cancer patients, their families, the general public and healthcare professionals in a personalized, confidential and timely manner. The phone service is also available to Canadians in many other languages through interpreters.