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Colorectal cancer screening

ColonCancerCheck program

ColonCancerCheck recommends that all Ontarians aged 50 and over be screened for colorectal cancer.

A Fecal Occult Blood Test (FOBT) is recommended for people aged 50-74 at average risk for colorectal cancer. If positive, a colonoscopy is strongly recommended within 8 weeks of referral.  The ColonCancerCheck program recommends that participants not be screened using FOBT for a ten year period after a normal colonoscopy; patients may start or resume FOBT screening ten years after a normal colonoscopy (Source: ColonCancerCheck Clinical Advisory Committee).  If the FOBT is negative, this test should be repeated once every two years.

For those at increased risk because of crohn's, ulcerative colitis or a family history of one or more first-degree relatives (parent, sibling or child) with a diagnosis of colorectal cancer, a colonoscopy is advised.  For family history cases, colonoscopy screening should start 10 years prior to the diagnosis of the family member or at age 50, whichever comes first.

Regional Colonoscopy Network (RCN)

The RCN will facilitate timely access to colonoscopy for +FOBT patients or patients with a first degree family history of colorectal cancer.

The RCN:

  • Facilitates timely access for +FOBT and family history colonoscopies

  • Offers flexibility to book at 4 regional hospitals

  • Uses local gastroenterologists and surgeons

  • Monitors wait times (average 3-6 weeks from referral to colonoscopy)

  • Provides genetics screen & referral if indicated

  • Is an expanded program for Symptomatic Patients - See below

Referral form:  click here for the referral form for the Regional Colonoscopy Network.


Regional Colonoscopy Network - SYMPTOMATIC PROGRAM 

The RCN is now available to take referrals for highly symptomatic patients suspicious of colorectal cancer requiring a timely colonoscopy.  If your patient is positive for cancer; the referral will automatically be forwarded to our Colorectal Nurse Navigator for seamless care and integral psychosocial support. Symptomatic inclusion criteria is based on the CCO symptomatic patient algorithm.


Click here for referral form for Regional Colonoscopy Network. 


Assessing colorectal cancer risk

Risk assessment is the first step in determining which screening method is right for each patient. For an overview of colorectal cancer screening risk assessment, view the Clinical Reference Card here.

Essential information for health care providers:

Research shows that a personalized message from a primary care provider to a patient is the most effective recruitment method to organized screening.

As ColonCancerCheck increases colorectal cancer screening for Ontarians, health care providers will need specific information to help individuals participate in the screening program. Click on one of the following links to find out more about the essential information to help deliver ColonCancerCheck to your patients.

Primary care providers

Nurses/Nurse practitioners 

Help Reduce the Number of Rejected FOBT kits. Let your patients know the following:

Click here to download the PDF version of the FOBT Tip Sheet.

Colorectal screening guidelines

Refer to the screening guidelines booklet here


To find out more about the Fecal Occult Blood test (FOBT), and to get additional information and resources on colon cancer prevention and screening, visit the Ministry of Health and Long Term Care website at ColonCancerCheck.ca 

On the program’s website, primary care providers will find relevant information, resources, and program details needed to promote and engage patients in colorectal cancer screening.

Ordering FOBT kits

Click on this link to order more FOBT kits for your practice.

For questions about colorectal cancer screening in Waterloo Wellington, contact:

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