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Screening Guidelines - Colon Cancer

The ColonCancerCheck program has two arms for colorectal cancer screening: average and increased risk.

Average risk

  • People ages 50 to 74 with no first-degree relative who has been diagnosed with colorectal cancer
  • No personal history of pre-cancerous colorectal polyps requiring surveillance or inflammatory bowel disease (i.e., Crohn’s disease or ulcerative colitis)

Increased risk

  • People with a family history of colorectal cancer that includes one or more first-degree relatives who have been diagnosed with colorectal cancer, but do not meet the criteria for colorectal cancer hereditary syndromes

ColonCancerCheck Screening Recommendations

Screening people at average risk of colorectal cancer

  • ColonCancerCheck recommends screening with a fecal occult blood test (FOBT) every two years for asymptomatic people ages 50 to 74 without a family history of colorectal cancer.
  • Abnormal FOBT results should be followed up with a colonoscopy within eight weeks.
  • People ages 50 to 74 without a family history of colorectal cancer who choose to be screened with flexible sigmoidoscopy should be screened every 10 years.
  • Due to insufficient evidence, the ColonCancerCheck program recommends against screening for colorectal cancer using metabolomic (blood or urine) tests, DNA (blood or stool) tests, computed tomography colonography, capsule colonoscopy and double contrast barium enema.

Screening people at increased risk of colorectal cancer

  • ColonCancerCheck recommends that asymptomatic people get screened with colonoscopy if they have a family history of colorectal cancer that includes one or more first-degree relatives with the disease. Screening should be begin at 50 years of age, or 10 years earlier than the age their relative was diagnosed, whichever occurs first

Read more at How Ontarians Participate.

Evidence-Based Quality Standards

Cancer Care Ontario’s Program in Evidence-Based Care (PEBC) has developed Fecal Occult Blood Test (FOBT) Laboratory Standards and Colonoscopy Standards and Guidelines to support consistent, high-quality care for Ontarians. The first of their kind in Canada, the standards help ensure consistent high-quality delivery of ColonCancerCheck across the province.

Surveillance Guidelines

To complement the colonoscopy standards, ColonCancerCheck adopted colonoscopy surveillance guidelines outlined in “Guidelines for Colonoscopy Surveillance After Polypectomy: A Consensus Update by the U.S. Multi-Society Task Force on Colorectal Cancer and the American Cancer Society."

Wait Time Guidelines

The Canadian Association of Gastroenterology (CAG) published a Canadian consensus on medically acceptable wait times and set benchmarks. ColonCancerCheck's program benchmarks (adapted from CAG Benchmarks) are eight weeks for those with an abnormal FOBT and 26 weeks for those with a family history of colorectal cancer.

Gastroscopy standards

The Gastroscopy Standards and Quality Indicators for Ontario document was developed to help inform the best practice standards for the Gastrointestinal (GI) Endoscopy Quality-Based Procedure (QBP). A systematic search of esophagogastroduodenoscopy guidelines was conducted, and an expert panel consisting of experts in gastroenterology, general surgery and thoracic surgery was convened to review and develop the standards and indicators.

Last modified: Thu, Aug 18, 2016
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