Ontario lowers colorectal cancer screening age to 45 starting July 1

Ontario will lower the starting age for publicly funded colorectal cancer screening to 45 on July 1, down from 50, and will allow people considered at increased risk to start screening at age 40 or 10 years earlier than the age of the youngest affected relative at diagnosis, the province announced May 7.

The change expands eligibility for screening through Ontario’s ColonCancerCheck program. The Ministry of Health estimates more than one million additional people will become eligible for publicly funded screening.

Under the current program model, patients under 50 need a referral following an examination—typically when signs or symptoms are present—to access screening. Starting July 1, newly eligible people will be able to get a fecal immunochemical test (FIT), a stool test, by contacting their health-care provider or by calling Health811, without a referral.

The province said eligible people aged 45 to 49 will begin receiving letters from ColonCancerCheck starting July 1 to help them connect to an initial screening test.

Ontario defines “increased risk” as having one first-degree relative (a parent, sibling or child) diagnosed with colorectal cancer before age 60, or more than one relative diagnosed at any age. People in that category will be eligible for publicly funded screening at age 40 or 10 years earlier than the age of the youngest affected relative at diagnosis.

Ontarians under 40 who receive a doctor’s referral following an examination will continue to be able to access publicly funded screening through the Ontario Health Insurance Plan (OHIP), the province said.

If a FIT result is abnormal, the province said the patient’s doctor, nurse practitioner or Ontario Health will contact them to provide support and arrange a follow-up colonoscopy.

Health Minister Sylvia Jones said in a statement that colorectal cancer rates are rising among younger people.

According to the province, ColonCancerCheck completes more than 780,000 FITs each year. The province also said colorectal cancer is the fourth most commonly diagnosed cancer in Ontario and is the second most common cause of cancer death among Ontario men and the third most common cause of cancer death among Ontario women.