Not enough Canadians being screened for colorectal cancer, leading to many unnecessary deaths
18 May 2011
Use of a simple, at-home screening test by Nova Scotians can prevent many unnecessary colorectal cancer deaths, according to a special report about colorectal cancer in Canadian Cancer Statistics 2011 released today by the Canadian Cancer Society, in collaboration with the Public Health Agency of Canada and Statistics Canada.
If 80% of Canadians aged 50+ were screened over the next 10 years, it is estimated that 10,000 to 15,000 deaths could be prevented.
Colorectal cancer is the second leading cause of cancer death in Nova Scotia, with an estimated 340 Nova Scotians dying from the disease in 2011. It is the fourth most commonly diagnosed cancer in the province and in Canada after prostate, lung and breast cancer. An estimated 830 new cases are expected in Nova Scotia in 2011. Although rates of colorectal cancer incidence have been declining in Canada over the past two decades, the number of new cases has increased substantially due to population growth and aging.
The Society recommends that Canadians aged 50 and over get screened every two years with a simple stool test (known as FOBT or FIT). But currently, only 32% of Canadians in this age group report having a screening test. For people with symptoms or at higher risk of colorectal cancer, it is important that they talk to their doctors
The Department of Health and Wellness has implemented a province-wide colorectal cancer screening program, the Colon Prevention Screening Program that is administered by Cancer Care Nova Scotia. This screening program seeks to help detect cancer and pre-cancerous growths in Nova Scotians aged 50-74.
“Screening allows for the early detection of cancer – even pre-cancerous changes – before people experience symptoms of disease,” says Maureen Summers, CEO of the Canadian Cancer Society in Nova Scotia. “Detecting cancer at an earlier stage can mean that it is easier to treat. We need to identify and overcome barriers to colorectal cancer screening so that more Nova Scotians make the decision to get screened on a regular basis. Screening has the power to save lives.”
The Colon Cancer Prevention Program offers the fecal immunochemical test (FIT), which is a simple, at-home kit that tests for trace amounts of blood in the stool. This can be a sign of colorectal cancer.
“It’s very important that doctors talk to their patients about screening,” says Summers. “Canadians who have discussed colorectal cancer screening with their doctors are more than twice as likely to get screened regularly.”
According to the 2009 Colon Cancer Screening in Canada survey, 71.7% of Canadians aged 50 to 74 who discussed colorectal cancer screening with their doctors are up to date with screening, compared to only 32.6% who have not had the discussion.
Some other facts about screening, according to the survey:
- 81% of Canadians are aware that screening tests exist and recognize the benefits of screening.
- 60% of Canadians do not understand that screening is a “health behaviour” that doesn’t require symptoms in order to be performed.
- Most Canadians are not familiar with the at-home test. Most are aware of colonoscopy (a more invasive test used for follow-up).
Risk factors and prevention
Risk factors for colorectal cancer include a diet high in red or processed meat, being overweight, physical inactivity, smoking and a family history of the disease. The best ways to reduce the risk of colorectal cancer – along with screening – are eating a healthy diet, being physically active in order to maintain a healthy body weight, not smoking and avoiding excessive drinking.
Diagnosis and treatment
After a positive screening test or symptoms such as bleeding, obstruction or abdominal pain, diagnosis is commonly made using a medical exam such as colonoscopy or sigmoidoscopy.
Treatment depends on the stage at diagnosis and may include surgery, chemotherapy or radiation.
Compared to other cancers, colorectal cancer has a moderate prognosis with a five-year relative survival rate of 63%. This is better than some cancers, such as lung (16% survival), but worse than prostate (96%) or breast (88%).
Canada has one of the best colorectal cancer survival rates in the world – slightly lower than the US, but better than most of Europe, including the UK and Scandinavia.
The five-year colorectal cancer survival has improved considerably – from 56% in 1992–94 to 63% in 2004–06. Survival is expected to continue to improve in the future as screening uptake increases.
Trends by province
Participation in screening varies widely across the country, with the lowest rate in Quebec and the highest in Manitoba and Ontario (the first two provinces to actively launch province-wide screening programs in 2007 and 2008 respectively). Nova Scotia’s Colon Cancer Prevention Program was initiated two years ago and became available province-wide in March 2011.
Get Screened Nova Scotian
The Canadian Cancer Society in Nova Scotia is urging people to join the fight against cancer by stopping it in its tracks. Screening for colon, breast and cervical cancer means that you have the power to detect cancer early or before it even becomes cancerous. The early detection of cancer means that the disease is often easier to treat. That’s why the Canadian Cancer Society is urging Nova Scotians to visit www.getscreenednovascotia.ca to learn more about cancer screening, sign-up for screening reminders and potentially save a friend’s life by inviting them to get screened as well.
Conclusions and recommendations
Treatment advances and screening have led to important reductions in colorectal cancer deaths and improvements in survival. However, further improvements will require the following:
- continued emphasis on screening, including:
o maximizing regular participation and retention in screening programs and enhancing their quality
o improving Canadians’ awareness about screening and the fact that screening is for people with no symptoms
- more research into the risk factors for colorectal cancer and effective prevention and treatment
“It is expected that one in 14 Canadians will be diagnosed with colorectal cancer in their lifetime”, says Dr. Geoff Porter, Ramia Chair in Surgical Oncology and professor of Surgery, QEII Health Sciences Centre and Dalhousie University. “Fortunately, research has led us to screening tests that have the power to detect cancer early, before it even becomes cancer in some cases. By becoming more aware of colorectal cancer, how to screen for it, how to prevent it, and how to recognize the early symptoms Nova Scotians can help ensure they are looking after themselves and their families.”
A survivor’s story
To his family, 64-year-old Ed Branton of Martin’s River is a walking billboard for the importance of regular colorectal cancer screening.
“Because of what happened to me, my doctor told me that my brothers and sisters should also be screened,” says Mr. Branton, diagnosed with colorectal cancer in June 2010. “4 out of 7 have taken the test and 3 of them have appointments.”
Like many Nova Scotians, Mr. Branton received his colon cancer screening kit in the mail and parked it on his kitchen counter without much thought. His wife had taken the test just one year earlier and her results came back negative. Mr. Branton felt great, considered himself healthy and had just had blood work done a month ago. He was sure he had nothing to worry about but took the test anyway. It was a reluctant move that saved his life. He was diagnosed with an aggressive form of colorectal cancer that was removed. Mr. Branton considers himself very fortunate to have had his cancer detected early and he hopes that more people make the decision he did – to be screened for colorectal cancer.
“It’s quite possible that I wouldn’t have been here to celebrate Christmas with my family,” says Branton. “I would encourage other Nova Scotians who receive this kit in the mail not to throw it away. It only takes a few minutes of your time and it could save your life.”
General highlights: Canadian Cancer Statistics 2011
- An estimated 177,800 new cases of cancer (excluding 74,100 cases of non-melanoma skin cancer) and 75,000 deaths from cancer are expected to occur in Canada in 2011.
- An estimated 6,100 Nova Scotians will be diagnosed with cancer in 2011 and 2,650 will die of the disease.
- More men than women are diagnosed with cancer, but the gap between the two sexes has narrowed in recent years (52% of cases are in men versus 48% in women).
- More than one-quarter of all cancer deaths – 27% – are due to lung cancer.
- The death rate for all cancers combined is declining for males in most age groups and for females under 70.
- There were no increases in death rates for most types of cancer in men or women. Notable exceptions include liver (both sexes), lung (women) and melanoma (men).
- The five-year relative survival rate for all cancers combined is 62%.
Canadian Cancer Statistics 2011 is prepared, printed and distributed through a collaboration of the Canadian Cancer Society, the Public Health Agency of Canada, Statistics Canada and provincial and territorial cancer registries.
The Canadian Cancer Society fights cancer by doing everything we can to prevent cancer, save lives and support people living with cancer. Join the fight! Go to fightback.ca to find out how you can help. When you want to know more about cancer, visit cancer.ca or call our toll-free bilingual Cancer Information Service at 1 888 939-3333.
For more information about Canadian Cancer Statistics 2011, visit cancer.ca.
Colon Cancer Screening in Canada
was commissioned by the Canadian Partnership Against Cancer and conducted from March 10 to April 17, 2009, by Angus Reid Public Opinion and the Applied Health Research Centre at St. Michael’s Hospital in Toronto. A total of 3,153 Canadians were randomly surveyed. The margin of error which measures sampling variability is +/- 2.1%. The results have been statistically weighted according to the most current education, age, gender and region Census data to ensure the sample is representative of the adult population aged 45 to 74 in Canada.
The Canadian Cancer Society is a national community-based organization of volunteers whose mission is the eradication of cancer and the enhancement of the quality of life of people living with cancer. When you want to know more about cancer, visit our website www.cancer.ca or call our toll-free, bilingual Cancer Information Service at 1 888 939-3333.