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Colorectal cancer: Quebec the only province without screening program

Three organizations are urging the Quebec government to implement a colorectal cancer screening program, the second leading cause of cancer death among men and women in the country. Quebec is the only Canadian province without such a program.

In a press release issued Wednesday, Colorectal Cancer Canada, the Quebec Cancer Foundation and the Canadian Cancer Society noted that nearly three years ago, a motion was unanimously adopted by the National Assembly calling for the implementation of the Quebec Colorectal Cancer Screening Program before the end of the Coalition Avenir Québec government’s mandate.

The program would offer screening to people aged 50 to 74 through systematic invitations (as is done, for example, for breast cancer screening). The burden would no longer fall on individuals who currently need to request the fecal immunochemical test for occult blood (FIT). Currently, about 40 per cent of this population gets screened, while the target level is 60 per cent, Barry D. Stein, CEO of Colorectal Cancer Canada, said in an interview.

He said he can’t explain why Quebec is taking so long to put an organized screening program in place. He believes the province has the resources needed to implement it.

“The program has been announced, it’s just that we haven’t actually implemented the program as such, and every year that I ask about it, there’s another excuse. Generally, it’s an IT issue that we’ve been waiting on for 15 years. But that’s not an excuse, and frankly, us, along with the Quebec Cancer Foundation and the Canadian Cancer Society, are saying enough is enough,” said Stein.

“It’s very frustrating,” he added. “[…] All politicians admit that we need a program, but for some unexplained reason, we don’t have one, and we are the last province in Canada — even the other territories have launched their programs. How can every other province do it and Quebec can’t? It’s impossible to understand, and the money is there.”

According to the most recent data, approximately 7,300 Quebecers will receive a colorectal cancer diagnosis this year, and 2,350 will die from it. Across Canada, 26,400 people will be diagnosed, 50 per cent of whom are of working age.

When detected at an early stage (stage 1), the survival rate for colon cancer exceeds 90 per cent, but this drops considerably when the disease is caught at an advanced stage. The net five-year survival rate for stage 4 is 11 per cent.

Another concerning trend is emerging with this cancer: the incidence rate among those under 50 is rising rapidly, to the point where some countries have decided to lower the age for colorectal cancer screening in order to detect it as early as possible. That’s the case in the United States, which in 2021 lowered the starting age for screening to 45.

The three organizations raising a red flag on Wednesday are asking the Quebec government to mandate the Institut national d’excellence en santé et services sociaux (INESSS) to study the possibility of lowering the screening age to 45 in the province.

Canadians born after 1980 now face a two to two-and-a-half times higher risk of being diagnosed before the age of 50 than previous generations.

The Canadian Press health coverage is supported through a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for this journalistic content.

–This report by La Presse Canadienne was translated by CityNews