Health Care Professionals

ColonCancerCheck

Letters to Patients


Letters to Patients (for Family Physicians)

The ColonCancerCheck program will be sending new types of correspondence to patients.

  1. Recall/Reminder Letters
  2. Positive Fecal Occult Blood Test (FOBT) Result Letters
  3. Invitation Letters to Patients Turning 50 Years of Age

Background

ColonCancerCheck, launched in April 2008, is Canada’s first organized population-based colorectal cancer screening program.  The goal of the program is to decrease mortality from colorectal cancer through early detection and treatment.

The program recommends screening with the ColonCancerCheck FOBT (green kit) every two years for average risk men and women 50 years of age and over.  FOBT screening repeated every two years has been shown to reduce mortality from colorectal cancer by 16%1.  For patients at increased risk who have a family history of the disease in a first-degree relative (parent, sibling or child), the program recommends screening with colonoscopy at age 50 or 10 years before the age of diagnosis of the affected relative, whichever is first.

Non-ColonCancerCheck FOBTs (red kit) continue to be available from community laboratories for diagnostic purposes, or for patients under the age of 50.

  1. Recall/Reminder Letters

    Effective August 2010, ColonCancerCheck began sending recall letters to past participants who are due to repeat biennial FOBT screening.  The letter advises the patient that it is time to be re-screened for colorectal cancer and that they should talk to their family doctor about screening. 

    Recall letters are not sent to patients who have had other colorectal cancer screening activity within the past two years since completing an FOBT.  This includes patients who have repeated the FOBT or had a colonoscopy or flexible sigmoidoscopy.  The program will also not send recall letters to patients who were previously mailed an invitation letter as part of the ColonCancerCheck invitation pilot program in 2009/10, who have withdrawn from ColonCancerCheck correspondence or for whom the program does not have a valid mailing address.

    Four months after the recall letter has been sent, the program will send a reminder letter to any participant who received a recall letter but did not submit an FOBT to a lab or complete other screening activity (e.g. colonoscopy, flexible sigmoidoscopy) within the four-month period.

  2. Positive Fecal Occult Blood Test (FOBT) Result Letters

    Currently, ColonCancerCheck sends letters to patients with negative or indeterminate FOBT results as well as contacting unattached patients with positive FOBT results directly to ensure they have access to follow-up assessment services.  Beginning in fall 2010, ColonCancerCheck will also send letters to attached patients who have a positive (abnormal) FOBT result.  The letter will recommend that the patient contact their family physician to discuss their test result.

    This correspondence is intended to ensure that patients are aware of their positive result and contact their family doctor for follow-up assessment.  Family doctors have primary responsibility for ensuring that patients with abnormal test results receive appropriate follow-up care.  Patients with positive FOBT results should be referred for colonoscopy.  The Canadian Association of Gastroenterology guidelines recommend colonoscopy within eight weeks of a positive FOBT result1.  Only 60% of participants with a positive FOBT result are receiving a colonoscopy within six months.

  3. Invitation Letters to Patients Turning 50 Years of Age

    In late 2010, ColonCancerCheck will begin sending letters to men and women turning 50 years of age to invite them to visit their family physician to discuss colorectal cancer screening.  In 2010/11 only, invitation letters will also be sent to Ontarians turning 51 and 52 years of age; this is a one-time initiative to encourage people who have not participated in colorectal cancer screening since the program’s launch in April 2008 to contact their family doctor to discuss screening. 

    Invitation letters are not sent to patients who have had colorectal cancer screening activity within the past five years, or a colonoscopy within the past 10 years.  The program will also not send invitation letters to patients who were previously mailed an invitation letter as part of the ColonCancerCheck invitation pilot program in 2009/10, who have withdrawn from ColonCancerCheck correspondence or for whom the program does not have a valid mailing address.

Should you have any questions, please contact ColonCancerCheck at 1-866-662-9233 or coloncancercheck@cancercare.on.ca.  You can also find answers to commonly asked questions at Frequently Asked Questions: Letters to Patients.

Bulletins and Q's and A's are also available on the Ministry of Health and Long-Term Care.


Letters to Patients (for Nurse Practitioners)

The ColonCancerCheck program will be sending new types of correspondence to patients.

  1. Recall/Reminder Letters
  2. Positive Fecal Occult Blood Test (FOBT) Result Letters
  3. Invitation Letters to Patients Turning 50 Years of Age

Background

ColonCancerCheck, launched in April 2008, is Canada’s first organized population-based colorectal cancer screening program.  The goal of the program is to decrease mortality from colorectal cancer through early detection and treatment.

The program recommends screening with the ColonCancerCheck FOBT (green kit) every two years for average risk men and women 50 years of age and over.  FOBT screening repeated every two years has been shown to reduce mortality from colorectal cancer by 16%1.  For patients at increased risk who have a family history of the disease in a first-degree relative (parent, sibling or child), the program recommends screening with colonoscopy at age 50 or 10 years before the age of diagnosis of the affected relative, whichever is first.

Non-ColonCancerCheck FOBTs (red kit) continue to be available from community laboratories for diagnostic purposes, or for patients under the age of 50.

  1. Recall/Reminder Letters

    Effective August 2010, ColonCancerCheck began sending recall letters to past participants who are due to repeat biennial FOBT screening.  The letter advises the patient that it is time to be re-screened for colorectal cancer and that they should talk to their family doctor or nurse practitioner about screening. 

    Recall letters are not sent to patients who have had other colorectal cancer screening activity within the past two years since completing an FOBT.  This includes patients who have repeated the FOBT or had a colonoscopy or flexible sigmoidoscopy.  The program will also not send recall letters to patients who were previously mailed an invitation letter as part of the ColonCancerCheck invitation pilot program in 2009/10, who have withdrawn from ColonCancerCheck correspondence or for whom the program does not have a valid mailing address.

    Four months after the recall letter has been sent, the program will send a reminder letter to any participant who received a recall letter but did not submit an FOBT to a lab or complete other screening activity (e.g. colonoscopy, flexible sigmoidoscopy) within the four-month period. 

  2. Positive Fecal Occult Blood Test (FOBT) Result Letters

    Currently, ColonCancerCheck sends letters to patients with negative or indeterminate FOBT results as well as contacting unattached patients with positive FOBT results directly to ensure they have access to follow-up assessment services.  Beginning in fall 2010, ColonCancerCheck will also send letters to attached patients who have a positive (abnormal) FOBT result.  The letter will recommend that the patient contact their family physician or nurse practitioner to discuss their test result.

    This correspondence is intended to ensure that patients are aware of their positive result and contact their family doctor or nurse practitioner for follow-up assessment.  Family doctors and nurse practitioners have primary responsibility for ensuring that patients with abnormal test results receive appropriate follow-up care.  Patients with positive FOBT results should be referred for colonoscopy.  The Canadian Association of Gastroenterology guidelines recommend colonoscopy within eight weeks of a positive FOBT result2.  Only 60% of participants with a positive FOBT result are receiving a colonoscopy within six months.

  3. Invitation Letters to Patients Turning 50 Years of Age

    In late 2010, ColonCancerCheck will begin sending letters to men and women turning 50 years of age to invite them to visit their family physician or nurse practitioner to discuss colorectal cancer screening.  In 2010/11 only, invitation letters will also be sent to Ontarians turning 51 and 52 years of age; this is a one-time initiative to encourage people who have not participated in colorectal cancer screening since the program’s launch in April 2008 to contact their family doctor or nurse practitioner to discuss screening. 

    Invitation letters are not sent to patients who have had colorectal cancer screening activity within the past five years, or a colonoscopy within the past 10 years.  The program will also not send invitation letters to patients who were previously mailed an invitation letter as part of the ColonCancerCheck invitation pilot program in 2009/10, who have withdrawn from ColonCancerCheck correspondence or for whom the program does not have a valid mailing address.

Should you have any questions, please contact ColonCancerCheck at 1-866-662-9233 or coloncancercheck@cancercare.on.ca.  You can also find answers to commonly asked questions at Frequently Asked Questions: Letters to Patients.

Bulletins and Q’s and A’s are also available on the Ministry of Health and Long-Term Care website.

Footnotes

1Cancer Care Ontario, ColonCancerCheck 2008 Program Report, www.cancercare.on.ca/cms/One.aspx?portalId=1377&pageId=9851#.
2Paterson WG, Depew WT, Pare P, et al for the Canadian Association of Gastroenterology Wait Time Consensus Group. Canadian consensus on medically acceptable wait times for digestive health care. Canadian Journal of Gastroenterology Vol 20 No 6 June 2006.

For More Information

For more information about ColonCancerCheck, call ServiceOntario INFOline at 1-866-410-5853.
Hours of operation : 8:30am - 5:00pm, Monday to Friday.
TTY 1-800-387-5559.
Email : ColonCancerCheck.moh@ontario.ca or
Visit : Cancer Care Ontario