Colorectal Cancer Screening
Colorectal cancer is cancer that can affect men and women that occurs in the colon or the rectum, also known as the large bowel or large intestine. Because cancers of the colon and rectum are very similar they’re called colorectal cancer.
Colorectal cancer can develop from abnormal tissue, called polyps that grow on the inner wall of the colon and rectum. Not all polyps are cancerous, but some polyps can turn into cancer if they are not removed. Pre-cancerous polyps can be removed if caught early. This is why it is important to get colorectal cancer screening early so that the polyps are found and removed and do not have time to turn into cancer.
Colorectal cancer often has no warning signs or symptoms until it is really serious.
Common signs of colorectal cancer include:
- Rectal bleeding, or any sign of blood after bowel movements
- Lasting changes in bowel habits such as: diarrhea or constipation for more than a few weeks
- Stools (poops) that are consistently more narrow than usual
- The feeling that you are not completely empty after a have a bowel movement (poop)
- New urgent feelings that you have to have a bowel movement that happens often
- Unexplained weight loss, tiredness, or exhaustion
Who should be screened for Colorectal Cancer?
People of Average Risk
The NWT Colorectal Cancer Screening Clinical Practice Guidelines recommend that men and women of average risk aged 50-74 are screening every 1 to 2 years with a fecal immunochemical test (FIT). You are considered average risk if:
- No signs or symptoms of colorectal cancer
- No personal history of colorectal cancer
- No immediate family (parent, sibling, child) history with colorectal cancer
- No genetic syndromes
- No inflammatory bowel disease (ulcerative colitis and Crohn’s disease)
People with an Increased Risk
If you are considered to have an increased risk for getting colorectal cancer you should begin screening at age 40, or ten years earlier than the youngest age that colorectal cancer was diagnosed in your family, whichever comes first. When you have a family history of colorectal cancer, the screening tool is a colonoscopy instead of the FIT. A colonoscopy lets the specialist check for abnormal tissue growths (polyps) in your colon using a thin, flexible tube with a tiny camera on the end. You are considered increased risk if:
- Have one immediate family (parent, sibling, child) has colorectal cancer and was diagnosed under the age of 60
- Have two immediate family (parent, sibling, child) has colorectal cancer at any age
People with a Special Risk
If you are considered to be special risk for getting colorectal cancer it is recommended that you are screened as directed by a specialist. You are considered special risk if:
- Family history of genetic syndromes: hereditary nonpolyposis colorectal cancer, familial adenomatous polyposis and attenuated adenomatous polyposis)
- Longstanding inflammatory bowel disease such as Crohn’s colitis or ulcerative colitis
How can I get Screened?
FIT kits are currently available in every NWT community. Book an appointment with your primary care provider to get screened FIT kit. If you are aged 50-74 and of average risk, you will complete a Fecal Immunochemical Test (FIT) every 1 to 2 year to be screened. This test is a simple one-and-done, at-home poop test that only requires one sample.
NEW TESTING METHOD: This test used to be a three-sample smear poop test. In June 2018 this was changed to a simple, 1-sample poke test.
In communities with hospital laboratories (Fort Smith, Hay River, Inuvik, Yellowknife) your primary care provider will give you a laboratory requisition to take to the lab to pick up a FIT to take home to complete. Once you’ve done the FIT at home you need to bring it back to the lab within 7 days.
In the communities without laboratories the FIT will be provided from the Health Centre or Health Cabin. Once you’ve done the FIT at home you need to bring it back to the Health Centre or Health Cabin within 7 days.
If you’re considered to have an increased or special risk or developing colorectal cancer, talk to your primary care provider for them to complete a referral to the specialist.
How to prepare for your FIT
There are no dietary restrictions, medication changes, or preparation required for the FIT.
Getting your FIT results
After completing your FIT and returning it to the laboratory or your health centre/cabin, the staff cannot immediately give you your results. The test is mailed to a laboratory for testing and in about two (2) weeks the results will go to your primary care provider to review.
If you have not heard from your primary care provider, contact them about your results. Some people may require further testing. If you require further testing your primary care provider will inform you and arrange the follow-up appointment.