Colorectal screening in Canada, 2023-24
Limits on colonoscopy as a primary test for screening individuals at average risk
In many jurisdictions, colonoscopy capacity is limited, and wait times to colonoscopy after an abnormal screen are longer than the national target of 60 days. Seven provinces and three territories limit the use of colonoscopy as a primary test for screening individuals at average risk.
Limits on colonoscopy
| P/T | Access is limited | Considering or planning to limit | No current plans to limit access | Guidelines on use of FIT and colonoscopy for screening individuals at average risk |
|---|---|---|---|---|
| YT | ✓ Referral required | ✓ | Current guidelines indicate that average-risk individuals should be screened by FIT, but guidelines are not enforced. | |
| NT | ✓ Referral required | Current guidelines indicate that average-risk individuals should be screened by FIT. | ||
| NU | ✓ Referral required | Current guidelines indicate average-risk individuals screenings by FIT scopes are performed out of territory for many communities in Nunavut. | ||
| BC | The Guidelines and Protocols Advisory Committee (GPAC) guidelines outline the screening recommendations. Average-risk individuals are recommended to have FIT. | |||
| AB | ✓ Referral required* | ✓ | Recommends FIT as the entry-level screening test for colorectal cancer in people aged 50–74 who are considered average risk. | |
| SK | ✓ Physician referral required | Current guidelines indicate that average-risk individuals should be screened by FIT. | ||
| MB | ✓ | Strongly recommend the use of FIT for average-risk screening. | ||
| ON | ✓ Physician referral required; FIT is strongly encouraged | ✓ Continue to consider additional strategies | The program continues to recommend against colonoscopy for screening people at average risk, however access is not limited by the program. | |
| QC | ✓ | Colonoscopy is not the recommended test for individuals at average and slightly increased risk.
Colonoscopy as a primary screening test is recommended only for individuals with moderately increased risk of developing CRC (according to family history of CRC). |
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| NB | ✓ | FIT is only available through the NB Colon Cancer Screening Program. Current guidelines do not recommend colonoscopy as a primary screening test for average-risk individuals. | ||
| NS | ✓ FIT is strongly encouraged | ✓ | Strongly recommend the use of FIT for average-risk individuals. Colonoscopy screening for average-risk individuals is strongly discouraged. | |
| PE | ✓ FIT is strongly encouraged | Current guidelines indicate that average-risk individuals should be screened by FIT. | ||
| NL | ✓ FIT is strongly encouraged | Strongly recommend the use of FIT for average-risk individuals every two years. |
*AB: There are some local CRC Screening Centres that will no longer accept referrals for average-risk colonoscopies.