Screening is the best way of finding colorectal cancer early. Most people ages 50 to 74 are at average risk of getting colorectal cancer, meaning they do not have a first-degree relative (parent, brother, sister or child) who has been diagnosed with colorectal cancer. It is recommended that people at average risk get screened with the fecal immunochemical test (FIT) every 2 years.
Fecal Immunochemical Test
A fecal immunochemical test (the recommended colorectal cancer screening test for most people, also called FIT) is a safe and painless at-home cancer screening test. FIT checks someone’s stool (poop) for tiny amounts of blood, which could be caused by colorectal cancer or some pre-cancerous polyps (abnormal growths in the colon or rectum that can turn into cancer over time).
The fecal immunochemical test, also called FIT. This illustration is not to scale.
Here is what you need to know about FIT:
The test only takes a few minutes to do.
You only need to collect 1 sample.
You can eat and take your medications (including vitamin C and blood thinners) as usual.
Once you collect your sample, mail it to LifeLabs using the postage-paid envelope included in your FIT package or drop it off to a LifeLabs Patient Service Centre within 2 days so that it can be tested at the lab within 14 days. See the Location Finder to find a LifeLabs Patient Service Centre near you.
Cancer Care Ontario will mail you a letter with your test result. Your family doctor or nurse practitioner will also get a copy of your test result from LifeLabs. View Letters to the Public to learn more.
If your test result is abnormal, it does not necessarily mean that you have colorectal cancer or polyps that could become cancer, but it does mean that additional testing is needed. ColonCancerCheck recommends that people with an abnormal result have a colonoscopy within 8 weeks. For more information on abnormal test results and colonoscopy see the Abnormal FIT Result Frequently Asked Questions page.
If your test result is normal, you should get screened in 2 years using FIT. It is important to keep getting screened with FIT every 2 years until age 74.
If LifeLabs cannot get a result from your test, you will need to repeat it.
For information on how to do a FIT, see the FIT Instructions page.
Flexible Sigmoidoscopy
Flexible sigmoidoscopy is a colorectal cancer screening test. During the test, a doctor or registered nurse endoscopist uses a small, flexible tube with a tiny camera on the end to look inside the rectum and sigmoid colon (lower part of the colon). They can also take biopsies (tissue samples) or remove polyps (abnormal growths that form on the lining of the colon or rectum). You do not need sedation (medication that helps you relax or sleep) or need to change your diet for a flexible sigmoidoscopy.
In Ontario, a doctor can do the test or, in some places, a specially trained registered nurse can do the test under the medical direction of a doctor as part of the Registered Nurse Flexible Sigmoidoscopy Program .
Who qualifies for flexible sigmoidoscopy?
You qualify for colorectal cancer screening at a registered nurse flexible sigmoidoscopy site if:
you are ages 50 to 74.
you are at average risk of getting colorectal cancer:You do not have a first-degree relative (parent, brother, sister or child) diagnosed with the disease.
You do not have a personal history of polyps that could become cancer (called pre-cancerous polyps) which requires future follow-up.
You do not have inflammatory bowel disease involving the colon (i.e., Crohn’s disease involving the colon or ulcerative colitis).
if you do not have any symptoms that could be linked to colorectal cancer.
if you are due for colorectal cancer screening, which means you have not had a FIT in the past 2 years, flexible sigmoidoscopy in the past 10 years or colonoscopy in the past 10 years.
Your family doctor or nurse practitioner has to order a flexible sigmoidoscopy for you. You cannot arrange to get the test on your own.
If you have questions about whether this test is right for you, please speak to your family doctor or nurse practitioner.
Colonoscopy
A colonoscopy is a test that allows a doctor to look at the entire colon using a long, flexible tube with a tiny camera on the end. During a colonoscopy, the doctor can also take biopsies (samples of tissue) or remove polyps that can become cancer over time (called pre-cancerous polyps).
A colonoscopy is not recommended to screen people who are at average risk of getting colorectal cancer. However, colonoscopy is recommended to screen people who are at increased risk of getting the disease. Colonoscopy can also be used to test people who have symptoms such as rectal bleeding or diarrhea.
It is very important that people with an abnormal FIT result have a colonoscopy within 8 weeks.
To learn more about what happens during a colonoscopy or what to do after getting an abnormal FIT result, see the Abnormal FIT Result Frequently Asked Questions page.
Tests not recommended for screening
ColonCancerCheck no longer recommends screening with the guaiac fecal occult blood test (gFOBT), which is now replaced by FIT. FIT is a better test and is easier to use.
The following tests are not recommended for average risk and increased risk screening because there is not enough research showing that they are a good way to check for colorectal cancer:
Metabolomic (blood or urine) tests
DNA (blood or poop) tests
Computed tomography colonography (a test that takes images of the inside of the colon by X-ray)
Double contrast barium enema (an older test that takes images of the inside of the colon by X-ray)
Capsule colonography (a small disposable capsule-sized camera that takes pictures of the colon after being swallowed)
