Colon cancer testing and prevention
What you need to know about colon cancer, including when and where you should get checked and tips to protect yourself.
Program eligibility update
As of July 1, 2026, Ontario is connecting more people to publicly funded colon cancer screening by lowering the eligibility age from 50 to:
- age 45 for all eligible average risk individuals
- age 40 for all eligible individuals at increased risk
This expansion will help over 1 million additional people connect to important screening services to detect and treat colon cancer sooner.
About colon cancer
Colon cancer is cancer of the large bowel (colon), which is the final part of the digestive tract. Rectal cancer is cancer of the last 6 inches of the colon. Together, they are called "colorectal cancer," or commonly called "colon cancer" or "bowel cancer."
Most cases of colon cancer begin as polyps. Polyps are abnormal growths that form on the lining of the colon or rectum that could turn into cancer over time.
Colon cancer is the fourth most common type of cancer diagnosed in Ontario and the second most common cause of cancer death in Ontario. But if colon cancer is caught early, 9 out of 10 people with the disease can be cured.
Symptoms
You should see your family doctor or nurse practitioner if you have any of these issues, which could be caused by colon cancer:
- blood (bright red or very dark) in your stool (poop)
- new and persistent diarrhea, constipation or the feeling that your bowel does not empty all the way
- new and persistent stomach discomfort
- you are losing weight and do not know why
- a drop in your red blood cell count (anemia) that is caused by low iron
- stools that are narrower than usual
Learn more about colon cancer from Ontario Health (Cancer Care Ontario).
Why get checked
Getting checked regularly can help find colon cancer early, when treatment has a better chance of working. Regular testing can also find polyps that could turn into cancer. You should get checked even if no one in your family has had the disease.
People usually get colon cancer later in life, with over 90% of cases diagnosed in people over age 50.
Encourage your friends and loved ones to get checked as well.
Get checked: average risk (at-home test)
You can do an easy-to-use at-home test, called a fecal immunochemical test (FIT), if you’re at average risk of getting colon cancer.
You are at average risk if you are ages 45 to 74 and have:
- no personal history of colon cancer, Crohn's disease involving the colon, ulcerative colitis or colon polyps that need testing with colonoscopy (polyps are abnormal growths that form on the lining of the colon), and
- no first-degree relatives (parents, siblings or children) diagnosed with colon cancer, or
- any of the following types of family history:
- only 1 first-degree relative diagnosed with colon cancer at age 60 or older
- 1 or more first-degree relatives diagnosed with colon polyps
- 1 or more second-degree relatives (including grandparents, grandchildren, nieces or nephews and aunts or uncles) diagnosed with colon cancer or colon polyps at any age
People at average risk of getting colon cancer should get checked for colon cancer with the FIT every 2 years starting at age 45. The FIT checks your stool (poop) for tiny amounts of blood, which could be caused by colon cancer or some types of polyps.
The FIT:
- is safe and painless
- can be done at home and only takes a few minutes to do
- only needs 1 stool sample
- allows you to eat and take medications as usual
- is free for people who qualify through the ColonCancerCheck program and have Ontario Health Insurance Plan (OHIP) coverage
- can be mailed to an Ontario address of your choice
Step 1: talk to a doctor or nurse practitioner about getting a FIT
A family doctor or nurse practitioner must order a FIT kit for you. To get a FIT kit, you can:
- talk to your family doctor or nurse practitioner
- visit Health811 online or call
811 (TTY: 711 ) if you do not have a family doctor or nurse practitioner - visit a mobile screening coach in certain regions
- contact your health centre or nursing station if you live in a First Nation community
Step 2: get a test mailed to you
In-Common Laboratories will mail a FIT kit to your address of choice in Ontario after your doctor or nurse practitioner has ordered you one.
Step 3: do the test
The test is simple and only takes a few minutes to collect a sample of stool (poop). You only need 1 sample, and you do not have to change your diet or stop taking medication before doing the FIT.
Follow these steps:
- Check your date of birth and name on FIT tube.
- Write the date you collect your poop on the FIT tube.
- Pee and flush before you poop (if you have to pee).
- Unfold the stool collection paper and put it inside the toilet bowl.
- Sit on the toilet and poop on the collection paper.
- Open the FIT tube by twisting and lifting the cap.
- Drag the poop with the stick. The poop should cover all of the grooves at the end of the stick, but the poop should not go past the grooves.
- Put the stick with your poop back into the FIT tube.
- Twist the FIT tube closed.
- Shake the tube.
- Flush your poop and the stool collection paper.
Learn more about how to do the FIT. FIT instructions are available in multiple languages.
Step 4: return your completed FIT
Return your completed FIT as soon as possible (ideally within 2 days of collecting your sample) to In-Common Laboratories:
- mail it using the pre-paid envelope
- drop it off at any Rexall location – for information about Rexall locations and pharmacy hours visit rexall.ca or iclabs.ca/FIT/locations
- if you picked up your FIT kit from a nursing station or health centre, follow the return instructions they gave you
Step 5: get the results
After you return your completed FIT, Ontario Health (Cancer Care Ontario) will mail you a letter with your FIT result. The letter will tell you if your FIT result is normal, abnormal or unsatisfactory.
Your family doctor or nurse practitioner will also get a copy of your result.
FIT test results
If your result is normal
If you are still age 45 to 74, you should get checked again in 2 years. Ontario Health will send you a reminder letter at that time.
If your result is abnormal
An abnormal result does not necessarily mean that you have colon cancer or pre-cancerous polyps, but it does mean that you need more testing. Polyps are abnormal growths that form on the lining of the colon or rectum that could turn into cancer over time. Your family doctor or nurse practitioner will usually recommend that you get a colonoscopy.
If you do not have a family doctor or nurse practitioner, please call Ontario Health toll-free at
ColonCancerCheck recommends that you have a colonoscopy within 8 weeks of an abnormal FIT result.
If your result is unsatisfactory
A result that is unsatisfactory means that the lab could not get a result from your test. Depending on your situation, you may receive a new FIT kit or be advised on other next steps.
Learn more about your FIT results.
Get checked: increased risk (colonoscopy)
A colonoscopy is an exam where a doctor looks at the lining of the entire colon using a long, flexible tube with a tiny camera on the end.
It should be used if you’re at increased risk for getting colon cancer, which means you have a family history of colon cancer that includes:
- 1 first-degree relative (parent, sibling or child) diagnosed with colon cancer before age 60, or
- 2 or more first-degree relatives diagnosed with colon cancer at any age
If this is the case:
- Talk to your family doctor or nurse practitioner. You have a higher chance of getting colon cancer and should get checked with a colonoscopy every 5 years.
- You should start getting a colonoscopy at age 40, or 10 years earlier than the youngest age your first-degree relative was diagnosed with colon cancer, whichever comes first.
Learn more about colonoscopies.
Some people who have had polyps (abnormal growths that form on the lining of the colon or rectum that could turn into cancer over time) removed from their colon may be at increased risk of getting colon cancer and may need to get checked regularly with a colonoscopy instead of the fecal immunochemical test (FIT).
People with inflammatory bowel disease (Crohn’s disease involving the colon or ulcerative colitis) may also be at increased risk for getting colon cancer and may need to get checked regularly with a colonoscopy instead of the FIT.
If you do not have a family doctor or nurse practitioner, visit Health811 online or call
Learn more about checking for colon cancer.
After your colonoscopy
The doctor doing the colonoscopy will send your family doctor or nurse practitioner your test results.
If your colonoscopy result is normal
The amount of time you should wait until getting checked again after a normal colonoscopy and the screening test you should use is based on your family history:
- Colonoscopy in 5 years for people at increased risk (if you have 1 first-degree relative who was diagnosed with colon cancer before age 60 or 2 or more first-degree relatives diagnosed with colon cancer at any age).
- FIT in 10 years for people at average risk (if you have no first-degree relatives diagnosed with colon cancer, or only 1 first-degree relative diagnosed with colon cancer at age 60 or older).
If your colonoscopy result is abnormal
Your colonoscopy may find polyps (abnormal growths that form on the lining of the colon or rectum that could turn into cancer over time), cancer or other diseases of the colon. The doctor doing the colonoscopy should give you your test results and talk to you about next steps, which may include more tests or treatment.
Costs
Getting checked for colon cancer is free if you qualify for the ColonCancerCheck program and have Ontario Health Insurance Plan (OHIP) coverage.
Tips to reduce your risk
To reduce the chance of getting colon cancer it’s important to:
- be physically active
- avoid alcohol or drink less – there is no safe amount
- live smoke-free (for example, quitting smoking cigarettes)
- eat high-fibre and lower fat foods (for example, fruits and vegetables)
- have milk, milk products and milk alternatives with added calcium
- limit red and processed meat (for example, bologna, salami)
- check if you are at high risk
- get checked regularly for colon cancer
Remind your friends and family
If you have a loved one who is age 45 or older and hasn’t been checked for colon cancer, encourage them to ask their family doctor or nurse practitioner about getting checked. When colon cancer is caught early, 9 out of 10 people with the disease can be cured.