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ColonCancerCheck

Screening and Research

Screening

How the Program Works

The Ontario Ministry of Health and Long-Term Care, in collaboration with Cancer Care Ontario, has launched a province-wide colorectal cancer screening program, ColonCancerCheck, aimed at reducing deaths from colorectal cancer by increasing early detection.

ColonCancerCheck provides funding to screen :

1. All average risk adults 50 years and older for colorectal cancer using the Fecal Occult Blood Test (FOBT) every two years.
   • Find out how to order FOBT kits
2. Those at increased risk (i.e. with a first degree family member with colorectal cancer) using colonoscopy beginning at age 50, or 10 years earlier than the relative’s age of diagnosis, whichever comes first.

Risk assessment is the first step in determining how an individual will move through the program. For unattached individuals (those without a primary care provider), they may obtain ColonCancerCheck information from a pharmacist or Telehealth Ontario. For those at average risk, an FOBT kit will be dispensed by a pharmacist or ordered through Telehealth Ontario. If the unattached individual is at increased risk for colorectal cancer, he or she will be directed to ColonCancerCheck and will be assigned to a primary care provider who has been identified as willing to accept unattached participants from the program for follow-up care. If you are a primary care provider who is willing to accept unattached participants for follow-up care, please visit Cancer Care Ontario.

Clinical Tools to Help You Screen

Clinical tools were developed by the Centre for Effective Practice in collaboration with the Ontario College of Family Physicians and other partners, including the Registered Nurses Association of Ontario and the Nurse Practitioners Association of Ontario, to support healthcare providers in the rollout of ColonCancerCheck. The tools consist of two documents :

• A synthesis of the evidence on the different screening tests available, including the risks and benefits of each, and
• A reference card with a 1-2-3 flow diagram and pamphlet, which describes the key components of ColonCancerCheck, including how it works and what it funds.

You can view the CEP tools at the following links :

• Clinical Tool: Screening Evidence Summary [PDF]
• Clinical Tool: Reference Card [PDF]

Screening Standards and Guidelines

A key component of ColonCancerCheck

Is the development of new evidence-based standards for both colonoscopy and FOBT, as well as the adoption of guidelines for colonoscopy surveillance.

Standards

Colonoscopy and FOBT standards were developed through Cancer Care Ontario's Program in Evidence-Based Care (PEBC) by an expert panel consisting of gastroenterologists, surgeons, physicians and scientists. The comprehensiveness of these standards makes them the first of their kind in Canada. Their development and adoption will ensure consistent high quality delivery of ColonCancerCheck across the province. These standards will be published in prominent peer-reviewed journals.

• Guaiac Fecal Occult Blood Test (FOBT) Laboratory Standards
• Cancer Care Ontario Colonoscopy Standards
  

Guidelines

ColonCancerCheck will be adopting the guidelines for colonoscopy surveillance intervals outlined in "Guidelines for Colonoscopy Surveillance After Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society," published in Gastroenterology (2006)

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Research

Read the current research on colorectal cancer, colorectal cancer screening and ColonCancerCheck :

• Ontario FOBT Project - Final Report, March 2006
• Canadian Task Force on Preventive Health Care - FOBT Recommendations
• FOBT Task Force Recommendations
• Cancer 2020 CCS-1513 Report Summary
• Cancer 2020 Background Report
• Colorectal Cancer Screening Pilot Report
• Focus on Colorectal Cancer in Ontario
• Improving the Management of Colorectal Cancer (Proceedings of CQCO Signature Event, June 23, 2003)
• Insight on Cancer: News and information about colorectal cancer