Colorectal cancer screening in Canada 2021/2022
Colorectal screening guidelines
All provinces and territories recommend screening asymptomatic, average-risk individuals between the ages of 50 and 74 or 75 every 12-24 months with a fecal test (FT). Most jurisdictions use the fecal immunochemical test (FIT); however MB uses the guaiac fecal test (FTg). Most jurisdictions have a screening interval of two years, with the exception of Northwest Territories and Alberta, with an interval of one to two years.
The Canadian Task Force on Preventive Health Care recommends screening start at age 50 with FOBT (either FIT or FTg). The US Preventive Services Task Force has recently changed their recommendations to suggest starting to screen people from ages 45-49; however no Canadian province or territory is considering lowering the start age of screening to 45 years at this time.
Provincial and territorial screening guidelines
| P/T | Start age | Interval | Stop age | Primary screening test | Criteria |
|---|---|---|---|---|---|
| YT | 50 | 2 years | 74 | FIT | Asymptomatic, average risk individuals |
| NT | 50 | 1-2 years | 74 | FIT | Based on clinical guidelines |
| NU | 50 | 2 years | 74 | FIT | Based on clinical practice guidelines |
| BC | 50 | 2 years | 74 | FIT | Asymptomatic, average risk individuals |
| AB | 50 | 1-2 years | 74 | FIT | Asymptomatic, average risk individuals |
| SK | 50 | 2 years | 74 | FIT | Asymptomatic, average risk individuals |
| MB | 50 | 2 years | 75 | FTg | Asymptomatic, average risk individuals |
| ON* | 50 | 2 years | 74^ | FIT | Asymptomatic, average risk individuals without a parent, sibling, or child diagnosed with colorectal cancer. People with inflammatory bowel disease (i.e. Crohn’s disease involving the colon or ulcerative colitis) and some people who have had polyps removed from their colon may need a regular colonoscopy instead of FIT. |
| QC | 50 | 2 years | 74 | FIT | Asymptomatic, average risk individuals |
| NB | 50 | 2 years | 74 | FIT | Asymptomatic, average risk individuals |
| NS~ | 50 | 2 years | 74 | FIT | Asymptomatic, average risk individuals |
| PE | 50 | 2 years | 75 | FIT | Asymptomatic, average risk individuals |
| NL | 50 | 2 years | 74 | FIT | Asymptomatic, average risk individuals |
ON: *In Ontario, people ages 50 to 74 with no symptoms or family history of colorectal cancer in a first-degree relative may choose to be screened with flexible sigmoidoscopy instead of FIT. It is recommended that eligible people who are screened with flexible sigmoidoscopy repeat the test every 10 years.
ON: ^People ages 75-85 may also screen with FIT at the PCP’s discretion.
NS: ~The last FIT kit is mailed shortly after the participant’s 74th birthday. Participants can request a new kit (if lost or expired) up until their 76th birthday.