New efforts
- Studies show that people who have a colonoscopy more than six months after an abnormal FIT are more likely to have an advanced stage colorectal cancer diagnosis.1 To support timely follow up and early detection during COVID-19, Ontario Health:
- Developed and disseminated pandemic clinical guidance documents to Regional Cancer Programs, endoscopists and primary care providers to help them prioritize and resume colorectal cancer screening and endoscopy services
- Developed a COVID-19 Regional Monitoring and Planning Tool to help Regional Cancer Programs monitor and improve colonoscopy wait times and support prioritization for people with an abnormal FIT result or people with symptoms over people with non-urgent indications (e.g., through triage and centralized intake and bookings where available).
- To improve screening participation for colorectal cancer, Ontario Health:
- Continues to help primary care providers who participate in a patient enrolment model (PEM) by providing the Screening Activity Report. This report identifies people who are due/overdue for screening or require follow-up after an abnormal fecal test. Ontario Health has also developed Screening Activity Reports for non-PEM physicians serving some rural First Nations communities to improve their follow-up rates using geography that aligns with First Nation community boundaries.
- Continues to support Regional Cancer Programs with annual campaigns to promote colorectal cancer screening by providing them with public-facing promotional materials (i.e., poster, postcard, social media posts and a regional news release). Ontario Health also collaborated with the Ministry of Health on public cancer screening promotion campaigns, including the translation of materials into other languages, to encourage screen-eligible people in Ontario to get screened.
- Supported the recovery of screening participation following the onset of COVID-19. This included gradually resuming cancer screening correspondence letters (invitation, recall and reminder letters) and developing a COVID-19 recovery toolkit for providers and Regional Cancer Programs (which included key messages, social media posts, fact sheet, phone scripts to promote screening).
- Implemented process and information technology system updates to improve access to FIT by reducing FIT requisition rejections caused by issues with Ontario Health Insurance Plan cards (e.g., expired cards).
- The Lung Cancer Screening Pilot for People at High Risk (the pilot) was launched in June 2017 at several hospitals in Ontario. On April 1, 2021, the pilot transitioned to the OLSP.
- Ontario Health is planning for expansion of the OLSP, which includes onboarding new screening sites across the province and implementing program enhancements identified during the pilot phase. The majority of remaining hub sites (designated Thoracic Cancer Surgery Centres) will be added from 2024 to 2026.
- To support COVID-19 pandemic recovery efforts, Ontario Health developed clinical guidance documents for lung screening site hospitals to support the gradual increase of LDCT scans and resumption of lung cancer screening services.
1 – Corley DA, Jensen CD, Quinn C, Doubeni CA, Zauber AG, Lee JK, et al. Association Between Time to Colonoscopy After a Positive Fecal Test and Risk of Colorectal Cancer Stage at Diagosis. JAMA. 2017; 317(16): 1631-1641
2 – Lee YC, Li-Sheng Chen S, Ming-Fang Yen A, Yueh-Hsia Chiu S, Ching-Yuan Fann J, Chuang SL, et al. Association Between Colorectal Cancer Mortality and Gradient Fecal Hemoglobin Concentration in Colonoscopy Noncompliers. J Natl Cancer Inst. 2017; 109(5): doi: 10.1093/jnci/djw269
