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Registered Nurse Flexible Sigmoidoscopy

In Ontario, flexible sigmoidoscopy can be performed by a physician or by a specially trained registered nurse under the medical directive of a physician as part of the Registered Nurse Flexible Sigmoidoscopy (RNFS) Program.

Eligibility Criteria

People are eligible for colorectal cancer screening with registered nurse flexible sigmoidoscopy if they meet the criteria below. Referral from a primary care provider is required.

  • Men and women ages 50 to 74
  • Average risk of colorectal cancer:
    • No first-degree relative who has been diagnosed with the disease
    • No personal history of pre-cancerous colorectal polyps requiring surveillance or inflammatory bowel disease (i.e., Crohn’s disease involving the colon, or ulcerative colitis)
  • Asymptomatic
  • Due for colorectal cancer screening:
    • No guaiac fecal occult blood test (gFOBT)* or fecal immunochemical test (FIT) in the past 2 years, flexible sigmoidoscopy in the past 10 years or colonoscopy in the past 10 years

*After June 24, 2019, gFOBT will no longer be recommended as a valid colorectal cancer screening test in Ontario.

How to Refer Patients

Primary care providers have the option of referring eligible people to get screened for colorectal cancer with flexible sigmoidoscopy.

If no RNFS site is available in a region, primary care providers can:

  • refer patients to the closest RNFS site in another region
  • refer patients to an endoscopist for flexible sigmoidoscopy
  • discuss other screening tests with their patients

To refer someone, request a referral form by contacting one of the sites listed below.



The Ottawa Hospital, Civic Campus

613-798-5555 ext. 10402