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Colon

Refer

Fecal immunochemical test (FIT) again available for colon cancer screening.

Eligible patients can pick up FIT kits from any public or private lab across the province with a referral from their health care provider. For more information please visit this page.

Registration

Asymptomatic patients between the ages of 50 and 74 can be registered in the BC Cancer Colon Screening program as follows:

Average risk patients – fecal immunochemical test (FIT)

Use the updated Standard Outpatient Lab Requisition and select the new 'Fecal Occult Blood, age 50-74, asymptomatic q2y (copy to BC Cancer Colon Screening)' option.

NOTE: FIT is NOT recommended for individuals less than 50 or over 74 years of age. Individuals between 75 and 85 years of age should be evaluated on a case-by-case basis. Regardless of age, FIT is not appropriate for individuals who are medically unfit to undergo colonoscopy.

Physicians do not have to complete the Colonoscopy Referral Form for patients with abnormal FIT results if BC Cancer Colon Screening is copied on the lab report. BC Cancer will facilitate the referral of these patients to the appropriate health authority for colonoscopy.

Higher than average risk patients – screening colonoscopy

Use the Colonoscopy Referral Form to refer patients for screening colonoscopy.

Higher than average risk is defined as having at least one of the following:

  • One first degree relative diagnosed with colorectal cancer diagnosed under the age of 60; or,
  • Two or more first degree relatives with colorectal cancer diagnosed at any age; or,
  • A personal history of adenoma(s).

Eligibility

BC Cancer Colon Screening promotes early detection and prevention of colorectal cancer. The program is NOT intended for:

  • Individuals who are up to date for colon screening.
    • Patients who have had a FIT in the preceding 2 years, or colonoscopy or flexible sigmoidoscopy in the preceding 10 years for average risk patients; or a colonoscopy in the preceding 5 years for higher than average risk patients.
  • Individuals who have a personal history of colorectal cancer, ulcerative colitis or Crohn’s disease.
    • These patients should continue to obtain care through their specialist or health care provider.
  • Individuals who currently have symptoms, e.g., rectal bleeding, persistent change in bowel habits, abdominal pain, unintentional weight loss or iron deficiency anemia.
    • These patients should be referred to a specialist. No FIT required.
  • Individuals who are on a definite surveillance plan through a specialist.
Resources

Education materials for health care providers, men and women are available at no charge from BC Cancer Colon Screening. To obtain resources, download the materials below, email the order form to screening@bccancer.bc.ca, or fax it to 604-877-6113.

Brochures

Forms

Guidelines & manuals

Reports

Instructions

Presentations

Resource libraries
Scientific publications

Videos


FIT Results
  • All lab providers in B.C. for Fecal Occult Blood testing using FIT are experiencing an issue affecting the test results.
  • The percentage of positive results is increasing suggesting that some borderline negative results are now testing positive.
  • It is estimated that this change in the measurements will affect approximately 5% of patients tested -- i.e. they will now have a screen positive result whereas previously they would have had a borderline negative result.
  • While the positive predictive value of FIT screening may be lower than it has been in the past, a positive FIT still places the patient at higher risk. The Colon Screening Program recommends colonoscopy follow-up for all screen-positive cases.
  • The Colon Screening Program does not recommend ordering another FIT as it is not possible to know if the patient is truly negative for polyps/cancer or if the patient has intermittent bleeding of polyps. Follow-up colonoscopy is recommended even if a patient has another FIT that is negative.
  • Patients who have had a positive test result will continue to be referred to their health authority for pre-colonoscopy assessment. Please continue to communicate that this result is common (more than 15 per cent require further testing) and that it does not mean that cancer was found.


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