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ColonCancerCheck

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What is colorectal cancer?
Colorectal cancer is the second most common cause of cancer deaths in North America. Most cases occur in persons over the age of 50 who do not have special risks for colorectal cancer. It is typically a slow growing cancer and therefore screening programs are particularly effective. Current information demonstrates that fewer than 20 per cent of men and women 50 years and older (screen eligible age group) are screened by any method.

What are the causes of colorectal cancer?
Lifestyle factors are associated - such as diet rich in red meat, high in fat; low vegetable intake and sedentary lifestyle. But regardless of lifestyle factors, people over 50 need to be screened.

Who should be screened for colorectal cancer?
All men and women 50 years of age and older should undergo screening for colorectal cancer. Guidelines recommend that individuals at average risk (individuals aged 50 or over who have no family history of colorectal cancer or any symptoms) should undergo screening with the fecal occult blood testing (FOBT) as part of the periodic health exam (Canadian Task Force on Preventive Health Care, 2001).

Individuals who are at increased risk because of a family history of colorectal cancer (one or more first degree relatives with colorectal cancer), have a positive FOBT, or with an abnormality detected at flexible sigmoidoscopy, should be referred for colonoscopy. For those at increased risk because of family history, screening should begin at the age of 50 years, or 10 years earlier than the relative's diagnosis, whichever comes first.

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Who is at increased risk of colorectal cancer?
It is estimated that in Ontario 10% to 12% of the population may be at increased risk for colorectal cancer.  Those with a family history of colorectal cancer in a first degree relative,are at increased risk. People at increased risk should receive an initial colonoscopy beginning at age 50, or 10 years earlier than the age at which their relative was diagnosed with colorectal cancer, whichever occurs first.

Family history plays a major role in 15% to 20% of those diagnosed with colorectal cancer. Also, 5% of cancers occur in persons with an identifiable familial genetic condition (for example, Hereditary Nonpolyposis Colorectal Cancer or HNPCC) or those who have long-standing inflammatory bowel disease (IBD). For the majority of individuals (75% of cases) the diagnosis comes "out of the blue".

What is a first degree relative?
A first degree relative is a biological mother, biological father, biological sister, biological brother, biological daughter or biological son. It does not include extended family members e.g.: aunt, uncle, grandparents, in-laws, step parents, step brothers, step sisters, etc.

Are other jurisdictions offering similar programs?
In 2007, Ontario joined a growing number of countries - including the United Kingdom, Australia, Italy, France, Finland and Israel - that are implementing organized FOBT screening programs.

Jurisdictions that have implemented population-based FOBT screening programs have reached participation rates of up to 70% in their initial years.

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Is there a familial colorectal cancer registry in Ontario?
Yes. Information on the Ontario Familial Colorectal Cancer Registry (OFCCR) can be found by clicking here The Ontario familial colorectal cancer registry provides a research infrastructure for studying genetic and non-genetic (e.g. environmental) factors that contribute to colorectal cancer.

If your patient is a member of the OFCCR and has questions regarding their participation, they can call 416-971-9800, ext. 1214, or email OFCCR@cancercare.on.ca.

For More Information

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Email : ColonCancerCheck.moh@ontario.ca or
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