The burden of colorectal cancer in Canada
It has been shown through randomized controlled trials and experience of colorectal cancer screening programs in Canada that colorectal cancer screening using a fecal test is effective at reducing colorectal cancer cases and deaths.1
Canada age-standardized incidence rate by age (50-64 and 65+), 2009 – 2018
Since the introduction of colorectal cancer screening programs across the country beginning in 2007, there has been a marked decline in colorectal cancer incidence rates by 15% in the 50-64 age group and by 23% in the 65+ age group, which are the target age groups for colorectal cancer screening.
Canada age-standardized incidence rate by age, 2018
The highest incidence of colorectal cancer is found in those over 50 years old. Although individuals at any age can develop colorectal cancer, organized screening programs for asymptomatic individuals focus on those aged 50 and older as they have the highest risk of developing colorectal cancer.
Current state of colorectal cancer screening in Canada
In Canada, 10 of the 13 provinces and territories have organized colorectal cancer screening programs. Although organized cancer screening programs are not available in all jurisdictions, screening services may be provided opportunistically by a primary care provider. In this report, data from Northwest Territories and Quebec reflects opportunistic screening. During the time period that data were collected, New Brunswick’s colorectal cancer screening program was not fully implemented province-wide.
Fecal testing is the most common entry level screening test for colorectal cancer. In Canada, all jurisdictions used the Fecal Immunochemical Test (FIT) as the entry level test except for Manitoba and Ontario which used the Guaiac Fecal Test (FTg) during the reporting period (2017-2018).
Additional information about colorectal cancer screening in Canada and the Canadian Task Force on Preventive Health Care’s 2016 guidelines can be found in the 2019-2020 colorectal cancer screening environmental scan.
1 – Levin, T.R., Corley, D.A., Jensen, C.D., Schottinger, J.E., Quinn, V.P., et al. Effects of organized colorectal cancer screening on cancer incidence and mortality in a large community-based population. Gastroenterology: 2015. DOI: https://doi.org/10.1053/j.gastro.2018.07.017.