About colon cancer

Colon cancer is cancer of the large bowel (colon), which is the final part of your digestive tract. Rectal cancer is cancer of the last six 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 growths in the colon or rectum that can turn into cancer over time.

People can be checked for colon cancer if they are:

  • average risk: people ages 50 to 74 who have no parents, siblings or children (first-degree relatives) who have been diagnosed with colon cancer.
  • increased risk: people with a family history of colon cancer (1 or more parents, siblings, or children with the disease).

People at average risk should get checked for colon cancer with an at-home test called the fecal immunochemical test (FIT) every 2 years starting at age 50. 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 eligible people through the ColonCancerCheck program
  • can be mailed to your address of choice

People at increased risk should get screened with a colonoscopy starting at age 50, or 10 years earlier than the age your first-degree relative was diagnosed with colon cancer, whichever comes first. How often you get screened depends on the age your first–degree relative was diagnosed.

Colon cancer is the fourth most common type of cancer diagnosed in Ontario. It is also the second most common cause of cancer death among Ontario men and the third most common cause of cancer death for women. But if colon cancer is caught early, 9 out of 10 people with the disease can be successfully treated and cured.

Symptoms

People usually have no symptoms or problems early on in the disease. As colon cancer grows over time, the following symptoms or problems may start:

  • low red blood cells (anemia) caused by a cancer that is bleeding
  • blood (either bright red or very dark) in the stool (poop)
  • unexplained weight loss
  • a change in bowel habits (new and persistent diarrhea, constipation or feeling that the bowel does not empty completely)
  • new and persistent stomach discomfort

Learn more about colorectal cancer.

When to get checked

Get checked regularly to find colon cancer early when it is more likely to be cured. 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.

Colon cancer usually develops 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 using an at-home test if you’re at average risk

You can do an easy-to-use at-home test if you’re at average risk for colon cancer. You are at average risk if you:

  • are ages 50 to 74
  • do not have a parent, sibling or child who has been diagnosed with colon cancer
  • have no signs or symptoms of colon cancer

Step 1: talk to a doctor or nurse practitioner about getting a test

A doctor or nurse practitioner must order an at-home test for you. To get an at-home test, you can:

  • talk to your family doctor or nurse practitioner
  • visit Health811 online or call 811 if you do not have a family doctor or nurse practitioner
  • visit a mobile screening coach
  • contact your health centre or nursing station if you live in a First Nation community

Step 2: get a test mailed to you

LifeLabs will mail a test to your address of choice in Ontario after your doctor or nurse practitioner has ordered you one.

Step 3: complete 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 don’t have to change your diet or stop taking medication before taking the test.

Follow these easy steps:

  1. Check your date of birth and name on FIT tube.
  2. Write the date you collect your poop on the FIT tube.
  3. Pee and flush before you poop (if you have to go).
  4. Unfold the stool collection paper and put it inside the toilet bowl.
  5. Sit on the toilet and poop on the collection paper.
  6. Open the FIT tube by twisting and lifting the cap.
  7. Scrape the poop with the stick.
  8. The poop should cover all of the grooves at the end of the stick, but the poop should not go past the grooves on the stick.
  9. Put the stick with your poop back into the FIT tube.
  10. Snap the FIT tube closed.
  11. Flush your poop and the stool collection paper.

Learn more about how to complete the at-home test. Test instructions are available in 35 languages.

Step 4: return your completed test

Return your completed test as soon as possible (ideally within 2 days of collecting your sample) to LifeLabs by:

If you live in a First Nation community, contact your health centre or nursing station to discuss drop-off options.

Step 5: get the results

After you get checked, Ontario Health (Cancer Care Ontario) will mail you a letter with your FIT result. The letter you receive will tell you if your test results are normal, abnormal or unsatisfactory.

Your family doctor or nurse practitioner will also get a copy of your result.

If your result is normal

If you are still between the ages of 50 to 74, you should get checked again in 2 years Ontario Health (Cancer Care Ontario) 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 additional testing is needed. Polyps are abnormal growths on the lining of the colon or rectum that can sometimes 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 Cancer Care Ontario toll-free at 1-866-662-9233 to talk about next steps.

ColonCancerCheck recommends that you have a colonoscopy within 8 weeks of an abnormal FIT result.

If your result is unsatisfactory

If your results are unsatisfactory, you must get a repeat test. A result that is unsatisfactory means that the test was rejected or invalid.

Learn more about your at-home test results. 

Get a colonoscopy if you’re at increased risk

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, meaning  you have a family history of colon cancer that includes one or more parents, siblings (brother or sister) or children with the disease. If this is the case:

  • Talk to your family doctor or nurse practitioner. You are at a increased risk of colon cancer and should get checked with a colonoscopy.
  • You should start getting a colonoscopy at age 50, or 10 years earlier than the age your relative was diagnosed with colon cancer, whichever comes first.
  • The amount of time you should wait until getting checked again after a normal result is based on your family history. Your doctor or nurse practitioner can help figure out when you should get screened for colon cancer again, and whatich screening test is best for you.

Learn more about colonoscopies.

Some people who have had polyps (growths that form on the lining of the colon or rectum) removed from their colon may be at increased risk of getting colon cancer and may need to be checked regularly with a colonoscopy instead of an at-home test.

People with inflammatory bowel disease (Crohn’s disease involving the colon and ulcerative colitis) may also be at increased risk for getting colon cancer and may need to get checked regularly with a colonoscopy instead of an at-home test.

If you do not have a family doctor or nurse practitioner, you can visit Health811 online or call 811. If you live in a First Nation community, you can contact your health centre or nursing station.

Learn more about checking for colon cancer.

After your colonoscopy

The doctor doing the colonoscopy will give your doctor or nurse practitioner your test results.

If your result is normal

The amount of time you should wait until getting checked again after a normal result is based on your family history. Your doctor or nurse practitioner can help figure out when you should get screened for colon cancer again, and whatich screening test is best for you.

If your result is abnormal

Your colonoscopy may find polyps (small growths that form on the lining of the colon or rectum) cancer or other diseases of the colon. The doctor doing the colonoscopy should provide your test results and talk to you about next steps. This may include more tests and/or treatment.

Costs

OHIP pays for colon cancer screening with both the at-home test (FIT) and colonoscopy, so there is no cost to you.

Tips to reduce your risk

  • maintain a healthy body weight
  • be physically active
  • limit alcohol intake
  • eat a well-balanced diet (lots of fruit and vegetables and high-fibre, lower-fat foods)
  • limit red meat and processed meat (for example, bologna, salami)
  • live smoke-free (for example, consider quitting smoking cigarettes)
  • get checked with the at-home test (FIT)

Remind your friends and family

If you have a loved one who is 50 or over and hasn’t been tested, encourage them to ask their doctor for the at-home test. Whether it be your parent, partner, sibling, child or friend, the chance of being cured is best when colon cancer is caught early.