Colorectal Cancer Association of Canada - CCAC

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fecal test program aims to reduce colon cancer deaths

Updated Fri. Jan. 11 2008 9:52 PM ET News Staff

In the coming months, Canadians in some provinces will be asked to do something they’ve never done before: take a sample of their stool as part of their annual check-up.

Ontario will be the first of several provinces to add a test that looks for blood in the stool, a test called the fecal occult blood test.

The test looks for the early signs of colorectal cancer, a disease that kills over 8,700 Canadians a year, with more than 20,000 new cases each year. Doctors hope the new screening test will cut the death rate.

Dr. Linda Rabeneck, regional vice president of Cancer Care Ontario, is behind Ontario’s upcoming campaign. Patients over 50 will be urged to have a fecal occult blood test every year.

The goal is to reduce cut the growing number of patients who are diagnosed with advanced and often untreatable cancer.

"This stool test picks up the cancer earlier, when there are no symptoms at all," Rabaneck explains.

The test can find blood in stool that often can’t be seen with the naked eye. A tiny sample of stool is placed on a chemically-treated pad. A special chemical solution is then put on top. If the pad turns blue, there is blood in the stool sample.

Patients whose fecal tests return positive for blood will then be advised to undergo a colonoscopy to confirm if there’s a cancer.

’Do I really have to do this?’

Family doctor Dr. June Carroll expects it may be difficult to get some patients to take part in the screening, because it’s not the most pleasant test. Patients must collect three consecutive samples of their stools at home and then bring the samples into a lab.

"Some people say it’s yucky, some people say `Do I really have to do this?’ But when you explain why, they are usually quite willing to," she says.

Some believe colonoscopies are a more effective screening tool. But supporters of the fecal testing say the stool test can screen millions of people at a minimal cost and minimal invasiveness.

In fact, in England, after a similar screening program was introduced in the area of Coventry and Warwickshire, the number of hospital admissions and deaths due to colon cancer were been cut in half within five years.

The results of that pilot screening program were published in the British Medical Journal journal, Gut.

"Yes, fecal occult blood testing does work," says Dr. Steve Goodyear of the University Hospitals Coventry and Warwickshire in the U.K. "Basically, the earlier the cancer is detected the more likely you are to receive an effective cure for that cancer."

He notes as well that fecal screening costs just a fraction of the price of primary colonoscopies done in an imaging lab.

Rabaneck says the British experience shows her that fecal testing is effective.

"Based on the British test, we can say if you do this simple at home test, if you do have a cancer that is silent, there is a good chance it will be detected."

The public launch of the new colorectal screening program in Ontario will be in March, to coincide with National Colorectal Cancer Awareness Month. Other provinces such as Alberta, Manitoba and Saskatchewan are planning to adopt the screening test too soon.

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