Screening tests help find colon cancer before any symptoms develop. Screening means checking or testing for disease before any symptoms of the disease develop.
If you’re 50 years or older, get screened for colon cancer every 2 years.
Colon cancer is 90% curable when caught early!
The Canadian Cancer Society recommends that ALL Ontarians ages 50 and over be screened for colon cancer regardless of gender or sexual identity.
Some people may need to get screened earlier or more frequently depending on their risk factors.
|Average risk, aged 50+||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 colorectal cancer may need to be tested more often and at an earlier age than people with average risk. Examples of what puts a person at higher than average risk include:
How can you tell if you’re at increased risk? Know your risk factors and talk to your health care provider or call Telehealth Ontario's Colorectal Screening Line at 1-866-828-9213 and speak to a representative about conducting a risk assessment.
An at home stool test, also known as the Fecal Occult Blood Test (FOBT) is the recommended screening test for colon cancer for people at average risk who are 50 or over. It’s safe, not invasive and recommended every two years.
This test finds blood in the stool that is not visible to the naked eye. Polyps and/or tumours in the colon have blood vessels that can release a trace amount of blood onto the stool when it passes by. Stool tests check for occult (hidden) blood. The stool test helps identify polyps before they become cancerous.
The presence of blood does not necessarily mean cancer. If blood is found, more testing is necessary to find out if it was caused by cancer.
The FOBT uses a chemical reaction on a paper card to find 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 separate stool samples over three different days, at home, and then mailing the kit to a lab for analysis.
It’s natural to be uncomfortable handling your own stool, but remember that this simple test can help save your life.
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 copy (PDF).
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. As an aside, if there’s blood in your stool or urine, it would be a good idea to have that checked out by your health care provider.
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, the width of a piece of paper, 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 movement, for two additional days, and 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 put the kit in the mail.
Some helpful tips:
The envelope is pre-addressed and the postage is pre-paid, so all you have to do is put it in the mail when you’re done or drop it off at a local community laboratory collection centre.
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 to the public in the spring of 2008 as the first population-based, organized colorectal screening program of its kind in Canada. This means that there is now a structured program in place in Ontario that is working to get every eligible Ontario resident regularly checked for colon cancer before they develop symptoms. They are doing this by promoting the test and ensuring that there are easy and efficient methods to obtaining it. As well, the ColonCancerCheck program ensures that there is a process in place to respond to the increased number of tests being carried out and that there are follow-up procedures in place.
The goals of ColonCancerCheck are to reduce deaths from colon cancer and to support health care 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 health care provider. If you do not have a health care 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 health care 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 using a camera that is inserted into the anus. On the down side, they are more invasive than FOBTs. On the upside, they can provide treatment as well as screening. If polyps are found during the test, they can usually be removed during the procedure. Growths that are too large to be removed and/or appear to be cancer are removed surgically at a later date and a biopsy is taken during the colonoscopy to get a sample of cells for testing.
A colonoscopy is the usual follow up test for people who have a positive FOBT result.
It is also the initial screening test used for people who have been identified as being at higher risk for developing colon cancer.
A colonoscopy is done in a hospital or clinic on an outpatient basis. The procedure usually takes about 30 45 minutes.
To get a colonoscopy, you need a referral from your doctor. If you don’t have a doctor, you can call Telehealth Ontario’s Colorectal Screening Line at 1-866-828-9213 Telehealth Ontario, and they will conduct a risk assessment with you. If you are high risk and qualify for a colonoscopy, they will connect you with a 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:
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.