Caroline Johnston knows firsthand the deadly toll of colon cancer. The 47-year-old Montrealer's father was diagnosed with colon cancer 12 years ago and died from the disease two years later.
When her father was first diagnosed, Johnston did not hesitate to book an appointment for her own colonoscopy. She recently underwent a second colonoscopy and still recommends to family and friends that they get screened.
“I definitely encourage people to go and have it done because early detection is better,” said Johnston.
But Johnston’s proactive attitude towards early detection and screening places her alongside a minority of Quebecers.
Colorectal cancer is the second-leading cause of cancer deaths in the Canada and the province of Quebec alone has an estimated 2,400 deaths a year attributed to the disease. Despite this, only 33 per cent of Quebecers, aged 50-74, have gone for a colorectal screening test according to a survey recently released by Ipsos Reid.
How is the province planning to improve its numbers and get Quebecers screened earlier and quicker? Well, to put it bluntly, they’re taking a do it yourself approach.
Announced in November 2010, Quebec launched a two-phase plan aimed at catching colorectal cancer earlier. The first phase deals with improving access to specialized colorectal clinics.
“Phase one is currently going on in eight clinics across Quebec that practice colonoscopies,” said Noémie Vanheuverzwijn, a media relations officer for Quebec’s Ministère de la Santé et des Services sociaux. “The goal is to really optimize the existing clinics so that we can accommodate the increasing number of patients.”
The second phase, which is scheduled to begin at the end of 2012, will invite men and women 50-74 by letter to participate in a program that will allow them to undergo a screening test from the luxury of their own home. Those who respond will be sent a test kit which will require them to provide a fecal sample. The kit, along with sample, is then sent to a lab where they can determine if a follow-up colonoscopy is necessary.
Ontario initially launched its home colorectal cancer screening program in 2008. Kits are given out through family doctors but they can also be bought at a pharmacy. The program has led to a significant increase in the number of people screened. In the last two years 50 per of Ontarians 50-74 have been screened through the kits or a colonoscopy, explained Andrew Morrison, a media relations officer for the Ontario Ministry of Health and Long-Term Care.
The province also saw an additional benefit.
“What we have discovered is that wait times are declining,” said Morrison. “We think the reason is that we’re not giving everyone colonoscopies, we’re determining through this screening system whether you’re a good candidate for a colonoscopy. And that makes for a better use of time in hospitals.”
Ontario is not alone. Prince Edward Island, Nova Scotia, and Manitoba have also established a colorectal cancer screening program. The remaining provinces, like Quebec, are in various phases of pilot projects aimed at figuring out the best way to establish a program.
“We’ve worked hard across the country to convince all the provinces to bring in a program,” said Barry D. Stein, the president of the Colorectal Cancer Association of Canada. “Every province has either agreed to bring it in and is planning to bring one in, or has already brought it in.”
Stein added that the northern territories would like to establish a program but have put plans on hold due to the lack of access to colonoscopy clinics.
Quebec has yet to decide on an exact kit but they have put out a call to tenders to manufacturers. Regardless, it seems that home screening kits should save the province money. Stein said that a colonoscopy can cost nearly $400 to $600 depending on province. Screening kits start at $5 but can go up to $20 depending on the manufacturer.
Even with the ease of home screening kits there still a certain “ick” factor. Johnston has been given the kits twice following visits to a family doctor but despite knowing the benefits of early detection, she said never considered using them.
“It’s kind of gross,” said Johnston. “I wouldn’t want to do it.”
