B.C.’s Colon Cancer Screening Program Moves Forward

British Columbia's new colon cancer screening program is moving forward with the availability of a new, easy-to-use test that will help save lives by supporting the early detection of this disease.

"Colorectal cancer is beatable and treatable when detected early through screening," said Minister of Aboriginal Relations and Reconciliation Ida Chong on behalf of Minister of Health Margaret MacDiarmid. "Screening saves lives and one of the main goals of this program is to help raise awareness and to have people over the age of 50 actively talking to their doctors about the benefits of colon cancer screening."

The screening program started April 1, 2013, with the availability of the publicly-funded fecal immunochemical test (FIT). The program is primary-care-based and will see physicians referring patients between the ages of 50 and 74 for testing to ensure that those British Columbians at most risk of developing colorectal cancer receive regular screening. Most patients will be referred for a FIT once every two years. Individuals who have a significant family history of colorectal cancer will be referred to their regional health authority for a screening colonoscopy.

"By highlighting the importance of early detection we hope to significantly increase screening rates, which will prevent colon cancer from developing or allow diagnosis at an earlier stage when it is close to 100 per cent curable. This program will save many lives in B.C.," said Dr. Max Coppes, president of the BC Cancer Agency.

Family physicians will provide patients with a test requisition, which they can take to their local community or private laboratory. The laboratory will provide the patient with the FIT and detailed instructions for use. Patients will need to return the test to the laboratory for processing and results will be provided to the family physician.

The colon cancer screening program will include a number of unique features, including health authority patient co-ordinators to provide support to patients who are referred for colonoscopy. Patient co-ordinators will be able to confirm eligibility of patients going for colonoscopy and will help ensure access for priority cases and most efficient use of colonoscopy resources.

The additional components of the program will roll out first in the Vancouver Island Health Authority, with the remaining health authorities coming on board in the spring and summer of 2013.

"Patient co-ordinators have been in place in Victoria and Nanaimo since 2012 as part of a project to improve quality and access to colonoscopy services," said Dr. Denis Petrunia, a Victoria gastroenterologist. "We have received very positive feedback from patients on the benefits to their care. Colon cancer is preventable and easily treated if detected early and this new program is good news for our patients."

Many aspects of the successful colon check pilot program will carry over into the new program, including the FIT, health authority patient co-ordinators, quality and performance standards and patient reminders. The new model builds on the experiences of the pilot program and ensures that family physicians have a strong role in the screening patient pathway.

"As a colorectal cancer survivor who had advanced disease, I underwent years of treatment and many surgeries. I have no evidence of the disease today, however, had my disease been detected early, years of pain and suffering could have been avoided," said Barry D. Stein, president of the Colorectal Cancer Association of Canada. "Colorectal cancer is preventable, treatable and beatable if caught in its early stages. Consequently, it is essential that men and women between the ages of 50 to 74 be screened before they have any signs or symptoms. We are very pleased that British Columbians will have access to a province wide FIT screening program that will ultimately result is the saving of many lives."

The BC Cancer Agency will provide overall leadership and provincial oversight of the new program.

"It is great news that B.C.'s colon cancer screening program is now in place to help save the lives of people like myself through screening with the easy to use FIT and increased awareness of this disease," said Deb Imada, Vancouver colorectal cancer survivor and Colorectal Cancer Association of Canada volunteer. "I was diagnosed after talking to my family doctor about what I thought was just a minor concern. I was only 43 - younger than the target age range for screening - and cancer didn't even cross my mind. That conversation literally saved my life."

The program includes fees for practitioners, specialists and laboratory medicine services that will be paid through B.C.'s Medical Services Plan. These costs will depend on how many patients participate in the program. Additional program expenditures related to introducing FIT, increasing public awareness, developing a centralized participant registry and developing a system for data collection and monitoring are estimated to be in the range of $5 million to $10 million annually, depending upon patient participation.

"Sixteen years ago my mother died of colorectal cancer. Because of this, in March 2012 I underwent a routine colonoscopy. I did not have any symptoms to suggest there might be a problem and as a nurse I was aware of what to look for," said Claire Cross. "During the procedure, a large tumour was found and surgery was scheduled. Afterwards my surgeon commented that had it been another three to four months, my prognosis would likely have been very different. I am a true believer in early detection through screening and I recognize the benefits and importance of implementing FIT testing for anyone over the age of 50 years."

For more information on colorectal cancer and B.C.'s new screening program, please visit:www.screeningbc.ca