One province and one territory are taking steps to lower the screening age for colorectal cancer, with more probing a similar change.
Earlier this week, Prince Edward Island announced it’s lowering the age to 45, with Nunavut confirming to Global News on Tuesday its plans to make the same change.
BC Cancer said in an email to Global News it is also investigating such an adjustment.
“While younger adults have a lower risk of colorectal cancer compared to older adults, emerging evidence has prompted BC to investigate lowering the starting age for screening,” said Dr. Fabio Feldman with BC Cancer. “Data collection and modelling work is now ongoing.”
Those actions has cancer survivor Barry Stein, who serves as CEO of Colorectal Cancer Canada, pleased because it could prevent more families from a “costly and traumatic” experience his family went through.
“So this program (screening) wouldn’t have helped me at that time, but it would have sensitized a lot more people about the disease,” he said.
Stein was diagnosed at the age of 41 in 1995. He said he ignored the symptoms he had and, by the time he was diagnosed, the cancer had metastasized to other parts of his body.
He ended up having to get four liver surgeries in New York. He also participated in chemotherapy treatments in Canada and an experimental vaccine trial in California.
That experience led Stein to become not only an advocate for himself, but for others and resulted in the founding of what was originally called the Colorectal Cancer Association of Canada. It later became Colorectal Cancer Canada.
The organization has since launched a ‘screen at 45 campaign,’ urging provinces and territories to lower their screening age.
“We really want to save lives and that is the purpose of doing it,” Stein said. “We don’t want people to have to go through what I went through, which was a very traumatic, costly and traumatic experience to myself and my family.”
Nova Scotia, New Brunswick, Alberta and Saskatchewan told Global News they are each reviewing recommendations, with Saskatchewan’s ColonCheck assessing evidence and the timeline to decrease the eligibility age.
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Manitoba, Quebec, the Northwest Territories and Newfoundland and Labrador said they are continuing to review evidence, though no changes are coming at this time.
A spokesperson for the Ontario government said on background it’s reviewing ways to strengthen care, but “at this time, it would be too early to confirm any changes.”
According to the Canadian Cancer Society, people under 50 are now two- to two-and-a-half times more likely to be diagnosed with colorectal cancer than they were in previous generations.
Dr. Enrique Sanz Garcia, a clinical investigator at the Princess Margaret Cancer Centre in Toronto, said those numbers are in line with what he’s seeing.
“This is something that we are seeing more often in our clinic at this point,” Sanz Garcia said.
He went on to tell Global News that while there aren’t confirmed causes explaining why colorectal cancer is presenting earlier in people, there are still factors linked to the disease itself.
Among them is a diet filled with high amounts of ultra-processed fats and a sedentary lifestyle.
“But the truth is that we are seeing many people who don’t have any of these risk factors and they still have cancer and colorectal cancer,” he said.
Guidelines in Canada currently recommend asymptomatic people with average risk between 50 and 75 to be screened using a fecal occult blood test. One of the most common is known as the fecal immunochemical test (FIT), an at-home screening tool that can detect blood in the stool, which may indicate colorectal cancer.
Sanz Garcia stresses if the FIT test does detect blood, it does not immediately mean you have cancer but people should then get a colonoscopy.
If you’re concerned about colorectal cancer even without family history or higher risk, he said people can look for some common symptoms, including bleeding, an alternation between constipation and diarrhea, abdominal pain and unexplained weight loss.
Yet he noted another reason for early screening is because many people can be asymptomatic.
“The reality is that most of the people that we are seeing in the clinic, they are caught by a screening,” Sanz Garcia said. “They are caught asymptomatic, they are caught because they go for the screening for colorectal cancer.”
— With files from The Canadian Press
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