Start screening for colorectal cancers earlier, Canadian Cancer Society urges

People as young as 45 should be invited to provincial and territorial programs to screen for colorectal cancer, the Canadian Cancer Society urged on Wednesday.

The recommendation to change the age of screening, which involves sending a stool sample to a lab, applies to people of average risk, like those without a family history of colon or rectal cancer. The call follows a news conference Tuesday on Parliament Hill, where colorectal cancer advocates from across the country also urged that the screening age be lowered.

“Canadians born after 1980 are now two and a half times more likely to be diagnosed with colorectal cancer before the age of 50 compared to earlier generations,” Barry Stein, president and CEO of Colorectal Cancer Canada, told reporters at the event.  

Indeed, emerging evidence suggests adults under 50 are increasingly being diagnosed with colorectal cancer. Current screening programs in Canada are offered to those aged 50 to 74. 

Higher cancer rates in younger adults are an indicator that colorectal cancer screening needs to start earlier, said Brandon Purcell, advocacy manager of prevention and early detection at the Canadian Cancer Society in Ottawa.

“Other countries like Australia, Japan, Taiwan, the United States have all made this move in response to recent evidence, and we think it’s time that Canada makes that move as well,” Purcell told CBC News. 

He says access to screening is often limited to those who have family doctors, which is why they’re also recommending that people be able to ask to be screened at clinics or through provincial programs. 

‘The worst day of my life’

Steve Slack of Bowmanville, Ont., started having abdominal pain and noticing changes in his bowel habits in 2018 when he was 46. 

He was diagnosed with food sensitivities and managed his diet, but the symptoms worsened. In 2021, Slack says he started seeing blood in his stool. He immediately had a colonoscopy.

The results showed a massive tumour that had broken through the colon wall, with scans later confirming 23 additional metastatic tumors on his liver. He was told he needed emergency surgery.

“I had to come home and tell my kids,” he said. “It was the worst day of my life. Like, absolutely, no one should have to tell their kids that.”

Slack’s colon was successfully treated, and he also had a disc-shaped device surgically implanted to deliver potent chemotherapy, shrinking the number of tumours to just one. In 2023, when scans showed that the single tumour remained, Slack had a liver transplant.

Today, Slack says his scans suggest no evidence of cancer. But he still attends support groups for people who have the disease where he meets other cancer patients who are his age.

He says they often tell him that they, too, had symptoms of colorectal cancer, but had a hard time getting a cancer diagnosis.

WATCH | Younger celebrities being diagnosed with colorectal cancer:

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Lowering screening age overdue, doctor says

Dr. Shady Ashamalla, who operates on young adult patients with colon and rectal cancers at Toronto’s Sunnybrook Hospital, says lowering the colorectal screening age is overdue. 

He pointed to high-profile celebrities who have died of the disease, including U.S. actors James Van Der Beek, who was 48, and Chadwick Boseman, who was 43.

“It is not a disease of the elderly anymore,” Ashamalla said. “And it used to be and so that’s a shift.”

He says colorectal cancer is curable if it’s caught early enough. But when younger patients aren’t screened or ignore symptoms then the disease can be significantly worse, he said.