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ColonCancerCheck

Frequently Asked Questions – Pharmacists

Background

1. What is the ColonCancerCheck program?
2. Why screen for colorectal cancer?
3. What is the role of the pharmacist in the ColonCancerCheck program?

Screening

4. Who is eligible to receive an FOBT kit at a pharmacy?
5. Who is not eligible to receive an FOBT kit at a pharmacy?
6. What if the individual has a first degree relative diagnosed with colorectal cancer?
7. What if the individual has had a colonoscopy within the last ten years?

Processes and Remuneration

8. How do I obtain my first set of FOBT kits?
9. How do I obtain more FOBT kits?
10. Where do I get a lab requisition form for FOBT?
11. What is the PIN (Product Identification Number) for the FOBT kit?
12. How does a pharmacist submit an FOBT claim?
13. What should pharmacists do with the FOBT requisition form?
14. What is inside the ColonCancerCheck FOBT kit?
15. What if the participant’s first test is inconclusive or rejected for processing and the participant is requesting another kit?
16. How often can FOBT kits be distributed to the same individuals?

Results and Further Information

17. How will participants who receive their FOBT kits from a pharmacist receive their results?
18. What if a participant presents at the pharmacy asking about their results?
19. What if I have additional questions about the ColonCancerCheck program?

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Background

1. What is the ColonCancerCheck program?

In January 2007, the Ontario government, in collaboration with Cancer Care Ontario (CCO), announced the first population-based provincial colorectal cancer screening program in Canada to decrease mortality from colorectal cancer through early detection and treatment. 

2. Why screen for colorectal cancer?

Colorectal cancer is the second leading cause of death from cancer in Canada. In 2010, an estimated 8,300 Ontarians will be diagnosed with colorectal cancer and 3,400 will die from the disease¹. There is a 90% chance of curing colorectal cancer if detected early through regular screening, but only a 10% chance of survival if detected at an advanced stage. Regular (repeated) screening using Fecal Occult Blood Test (FOBT) has been shown to decrease mortality from colorectal cancer by a minimum of 16%. But according to 2007-2008 data from the Cancer System Quality Index, only 30% of Ontarians aged 50 years or over had an FOBT in the previous two years.

3. What is the role of the pharmacist in the ColonCancerCheck program?

Pharmacists have an important role in helping Ontarians who do not have a family doctor or nurse practitioner access screening for colorectal cancer by:

• Dispensing program-branded FOBT kits to eligible unattached participants
• Providing information about the importance of screening for colorectal cancer
• Referring individuals at increased risk (family history of colorectal cancer in a parent, sibling or child) to the ColonCancerCheck program at 1-866-662-9233

Pharmacists are not required to recruit eligible individuals to participate in the program.

Note: ColonCancerCheck supports Ontarians at increased risk of colorectal cancer by arranging appointments with primary care providers who are willing to accept participants for referral to follow up care, typically colonoscopy.

 

Screening

4. Who is eligible to receive an FOBT kit at a pharmacy?

To be eligible to receive an FOBT kit from a pharmacy, an individual must meet all of the following criteria:

• Ontarians 50 years of age and over with a valid Ontario Health Card
• Those without a primary care provider (unattached)
• Those at average risk of developing colorectal cancer i.e. no first-degree relatives (parent, sibling, child diagnosed with colorectal cancer)
• Those who have not had a colonoscopy within the past 10 years
• Those who have not completed an FOBT in the past two years

Ontarians aged 50 years and over without a primary care provider may obtain an FOBT requisition form at their community pharmacy to determine eligibility for the program. The FOBT requisition form includes five brief screening questions to determine eligibility. Participants need to answer “no” to all of the screening questions in order to be eligible to receive an FOBT at a pharmacy. Please refer to the tip sheet included with the FOBT requisition forms on where to redirect individuals who answer “yes” to any of the screening questions.

5.  Who is not eligible to receive an FOBT kit at a pharmacy?

Please do not provide FOBT kits to individuals with the following:

• Unexplained changes in bowel patterns
• Rectal bleeding
• Unexplained weight loss
• Urgent feeling to empty bowel
• Unexplained stool incontinence
• Unexplained anemia
• Those with a primary care provider (attached)

Those experiencing one or more of the symptoms described above may require medical attention and must be directed to seek appropriate medical care.

Note: Individuals who regularly use the service of walk-in clinics (e.g. those who obtain monthly blood pressure medications from the same clinic) may obtain their FOBT kits from these clinics to facilitate provision of results and follow-up care.

6. What if the individual has a first degree relative diagnosed with colorectal cancer?

Individuals at increased risk of colorectal cancer (with a first-degree relative, e.g. parent, sibling, child diagnosed with colorectal cancer) should be referred to their physician for screening.

 Those at increased risk who do not have a primary care provider should be referred to the ColonCancerCheck program at 1-866-662-9233, which will arrange an appointment with a primary care provider who is willing to accept participants for referral to follow up care, typically colonoscopy.

7. What if the individual has had a colonoscopy within the last ten years?

If the individual has a doctor or nurse practitioner, they should be referred to their primary care provider to discuss the appropriate time to repeat screening.

Individuals who have had a colonoscopy within the last ten years may not require an FOBT. At the time of the colonoscopy, the physician should have indicated when to repeat the colonoscopy.

If they no longer have a primary care provider, please refer them to the ColonCancerCheck program at 1-866-662-9233 for a subsequent referral to a primary care provider.

If the individual cannot remember when they last had a colonoscopy but meets other eligibility criteria described above, they may obtain an FOBT kit from the pharmacy.

Processes and Remuneration

8.  How do I obtain my first set of FOBT kits?

Please call INFOline at 1-866-410-5853 and the ColonCancerCheck program will arrange for your first set of FOBT kits to be sent to you.

9. How do I obtain more FOBT kits?

If you have a re-order form, you should complete it and send it back to the laboratory.  If not, please call your laboratory supplier who will help you to obtain additional kits.  If you do not know who your lab supplier is, please contact INFOline at 1-866-410-5853, who has a list of labs associated with each pharmacy and they will be able to further assist you.

10. Where do I get a lab requisition form for FOBT?

Pharmacists have been mailed a pad of requisition forms, which you should have received.

You may also obtain a pharmacy laboratory requisition form from the ColonCancerCheck.ca website.  Click on "Pharmacist" and "Lab requisition" to view or print a copy.  Blank forms can be photocopied as you require.

Alternatively, you can download the form from the Ontario.ca website under their "Forms" repository.  After choosing a language (English/French), click under the "Resources" banner on the "Forms" item.  Type the form number 4533-84 into the "Quick Search" window to find the form.

11.  What is the PIN (Product Identification Number) for the FOBT kit?

The PIN for the FOBT is 93899960.

12. How does a pharmacist submit an FOBT claim?

After the pharmacist has reviewed the requisition form for eligibility and completeness, an online FOBT claim can be submitted via the Health Network System (HNS). No software system changes are required.

An FOBT claim must be submitted on the Health Network System with the following information:

Participant Gender	“F” = female, “M” male
Participant Date of Birth	YYYYMMDD
Participant Health Card #	As noted on Health Card
Product Identification Number (PIN)	“93899960” = FOBT PIN
Intervention code	“PS” = Professional Care Service “ML” = Eligibility established – Standard coverage
Carrier ID	“G” = ColonCancerCheck Plan Code
Pharmacist’s ID code	Pharmacist License #
FOBT Fee	$7.00

 

13. What should pharmacists do with the FOBT requisition form?

After submitting the online FOBT claim, pharmacists are asked to affix the prescription label on the FOBT requisition form and ensure completeness of the form prior to signing it. The prescription label provides details to the participating laboratory in case the information on the FOBT requisition form is unclear. You may be contacted by the participating laboratory staff to clarify details on the FOBT form or if the form is not completely filled out. ColonCancerCheck will use the information on the FOBT requisition form to follow up with the participant on test results.

Note:  The Pharmacy ID, as requested on the FOBT requisition form, is the unique identification number assigned to your pharmacy. It is the ten digit Canadian Pharmacists’ Association (CPhA) number for accredited community pharmacies that begins with “ON”. You may wish to note your Pharmacy ID on the tip sheet attached to the pad of requisition forms for quick and easy referencing.

The FOBT kit must be provided to the individual together with the completed and signed requisition form. Once the FOBT test is completed at home, the kit together with the requisition form may be dropped off at a participating laboratory or mailed to the laboratory in the pre-paid self-addressed envelope provided. Completed FOBT kits should NOT be returned to the pharmacy.

14. What is inside the ColonCancerCheck FOBT kit?

The ColonCancerCheck FOBT kit includes easy-to-read instructions, a test card, specimen collection sticks, privacy statement, an expiration date, a leak-proof envelope to protect the test card, and a pre-paid self-addressed return envelope.

15. What if the participant’s first test is inconclusive or rejected for processing and the participant is requesting another kit?

If the test is inconclusive or rejected, the participant will receive a letter from the program informing the participant that the test was not processed or that the test was inclusive (neither positive nor negative), and will be directed to a pharmacy or to Telehealth Ontario to obtain a new FOBT kit. 

Pharmacists should re-assess whether the participant meets the eligibility criteria before providing another FOBT kit.

16. How often can FOBT kits be distributed to the same individuals?

Participants at average risk should be screened with FOBT once every two years.

In the case where the individual has lost or damaged their FOBT kit, pharmacists can provide another kit and submit another FOBT claim. A new requisition form will need to be completed if the previous one is no longer available (e.g. lost or damaged).

 

Results and Further Information

17. How will participants who receive their FOBT kits from a pharmacist receive their results?

For participants with a negative FOBT, the ColonCancerCheck program will send them a letter informing them of their results. They will also be reminded by the program to take the test again in another two years.

For participants with a positive FOBT, the ColonCancerCheck program will arrange an appointment with a family physician to facilitate follow-up care which may include a referral for colonoscopy. A positive FOBT does not mean that the participant has cancer, as 10% of participants with a positive result in one window will have cancer.

If a participant has not heard from the ColonCancerCheck program about their results within a month of completing the test, the participant should call 1-866-662-9233.

18. What if a participant presents at the pharmacy asking about their results?

Participants wishing to inquire about their results should be directed to contact ColonCancerCheck at 1-866-662-9233.

19. What if I have additional questions about the ColonCancerCheck program?

Pharmacists can obtain more information about the ColonCancerCheck program by calling 1-866-662-9233
or by visiting ColonCancerCheck.ca.

 

1 Canadian Cancer Society/National Cancer Institute of Canada: Canadian Cancer Statistics 2007.