Colon Cancer Screening

a. Colon cancer is cancer of the large bowel (colon), which is the lower part of the digestive system. Rectal cancer is cancer of the last six inches of the colon. Together, they are called ‘colon cancer’, but commonly called ‘colon cancer’ or ‘bowel cancer’. Colon cancer is the second-leading cause of cancer deaths in Ontario for both men and women. The good news is that colon cancer is 90% curable when caught early through cancer screening. There are no physical signs or symptoms during the early stages of this slow growing cancer which is why it is important to get screened.

ColonCancerCheck is the provincial colon cancer screening program. The program recommends that men and women between the ages of 50 and 74 years, with no first-degree family history (parent, sibling or child) of colon cancer, complete a take-home ColonCancerCheck fecal immunochemical test (FIT) kit.

Ontario’s Transition to the fecal immunochemical test (FIT)

As of June 24, 2019, Ontario has transitioned from the fecal occult blood test (FOBT) to FIT for colon cancer screening.

FIT is a simple, safe and painless at-home cancer screening test that checks your stool (poop) for tiny amounts of blood, which could be caused by colon cancer and/or pre-cancerous polyps (growths in the colon or rectum that can turn into cancer over time).

FIT offers several advantages over FOBT:

  • FIT is a more sensitive screening test, which means it is better at detecting colon cancer and some pre-cancerous polyps than FOBT;
  • FIT is more user-friendly because the collection device is easy to use and reduces the amount of contact people have with their stool when collecting it;
  • Only one stool sample is needed with FIT; and
  • When completing FIT, there are no medication or dietary restrictions (including vitamin C).

People in Ontario can talk to their health care provider about getting checked for colon cancer with FIT.

  • If someone does not have a health care provider, they can call Telehealth Ontario at 1-866-828-9213, or the Screen for Life Coach at (807) 684-7777 or 1-800-461-7031
  • If someone lives on a First Nation reserve, they can contact their health centre or nursing station.

LifeLabs will mail eligible people a FIT kit following a request from their health care provider. Screening participants should mail their completed FIT to LifeLabs or drop it off at a LifeLabs Patient Service Centre as soon as possible.

Cancer screening participants will continue to receive result letters from Cancer Care Ontario.

What if I have just received, completed, or still have a valid fecal occult blood test (FOBT) kit?

You should wait 2 years after your FOBT before doing a fecal immunochemical test (FIT).

Labs will keep testing FOBT kits until December 24, 2019. This means you can still get your test result if you did an FOBT before FIT was available.

You must complete and return your FOBT kit before December 24, 2019. If you cannot return your FOBT before December 24, 2019, you should talk to your family doctor or nurse practitioner about doing a FIT instead.

If you have an FOBT kit, but would rather do a FIT, talk to your family doctor or nurse practitioner about switching tests.


When should I be screened for colon cancer?

ColonCancerCheck recommends that people who have no symptoms and are at average risk of colon cancer get screened with FIT every two years.

“Average risk” is defined as people ages 50 to 74 with no first-degree relative (parent, brother, sister or child) who has been diagnosed with colon cancer.

People with abnormal FIT results should have a colonoscopy within eight weeks of their abnormal results.

If someone ages 50 to 74 with no symptoms or family history of colon cancer chooses to get screened with flexible sigmoidoscopy instead of FIT, they should be screened again in 10 years.

ColonCancerCheck recommends that people who have no symptoms and are at increased risk of colon cancer get screened with a colonoscopy. Someone at increased risk should start screening at age 50, or 10 years earlier than the age their relative was diagnosed with colon cancer, whichever comes first.

“Increased risk” is defined as people with a family history of colon cancer that includes at least one first-degree relative (parent, brother, sister, or child) who has been diagnosed with this disease.

The ColonCancerCheck program does not recommend regular screening for people younger than age 50 with no first-degree relatives (parent, brother, sister or child) who have been diagnosed with colon cancer. Even though the number of colon and rectal cancers being diagnosed in younger adults is increasing in Canada, it is still very low in adults younger than age 50.

Where can you get a colonoscopy?

In Northwestern Ontario, a colonoscopy is performed in a hospital and requires a doctor’s referral. Speak to your health care provider about the colon cancer screening test that is best for you.
Access to a screening colonoscopy at Thunder Bay Regional Health Sciences Centre can be directed through the Diagnostic Assessment Program (DAP). The DAP provides a single point of access for screening colonoscopy if you have a positive FOBT test or have first-degree family history of colon cancer. Ask your doctor to refer you directly to the DAP where a patient navigator will work with you to ensure you receive timely access to care.


For more information on the colon DAP click here.

Cancer Screening:

  • If caught early, there is a 90% chance of curing colon cancer.
  • Men and women, 50 years and older, should screen for colon cancer.
  • Cancer screening finds cancer earlier, when it is easier to treat.
  • The Screen for Life Coach offers breast, cervical, and colon cancer screening services.
  • We work with Cancer Care Ontario to offer organized cancer screening programs for adults in our region. Visit cancercare.on.ca for more information.