Study reveals low rates of colorectal cancer screening in Canada, despite established guidelines and good access to family physicians

September 10, 2007

A new study published in the Canadian Medical Association Journal (CMAJ) reveals that only 18 per cent of eligible Canadians are receiving colorectal cancer screening within the recommended time frame. The study included 12,776 men and women in four Canadian provinces (British Columbia, Saskatchewan, Ontario, and Newfoundland and Labrador) who were aged 50 or older and were at average risk for colorectal cancer.

“Our research shows that the rate of colorectal cancer screening in Canada is unacceptably low, despite excellent evidence of its effectiveness and clear guidelines published in 2001,” said lead author Dr. Ryan Zarychanski, a physician and research fellow at The Ottawa Hospital, the Ottawa Hospital Research Institute and the University of Ottawa. “We also found that seeing a family doctor regularly increases access to screening, but only to about 21 per cent.”

In Canada in 2007, about 20,460 new cases of colorectal cancer will be diagnosed and about 8,700 people will die from this disease, making it the second leading cause of cancer deaths in Canada. If colorectal cancer is detected early, the mortality is low, with 90 per cent of patients surviving five years. In 2001, the Canadian Task Force on Preventative Health Care published guidelines recommending fecal occult blood testing every two years and sigmoidoscopy / colonoscopy every 10 years to screen for colorectal cancer in people of average risk.

“People should be aware that their chances of dying from colon cancer can be dramatically reduced through screening, and they should therefore discuss colorectal cancer screening with their family doctor and insist on screening if they are eligible,” said Dr. Zarychanski. “Although the reasons for inadequate screening are complex and include factors such as a lack of organized screening programs and general uneasiness discussing problems in this part of the body, one can’t say that doctors themselves don’t believe in colon cancer screening since we know that 50 per cent of doctors have undergone screening themselves.”

Dr. Zarychanski, a Canadian-trained hematologist and intensive care specialist, conducted the research as part of ongoing graduate studies in the Department of Epidemiology and Community Medicine at the University of Ottawa. Data for the analysis was obtained from the 2003 Canadian Community Health Survey, conducted by Statistics Canada.

In a CMAJ editorial that accompanies the research paper, Drs. Alan Barkun and Ken Flegel argue that physicians must take on a more active role in promoting colorectal cancer screening. A related news item in the journal provides information on the existing colorectal cancer screening programs in three provinces, and the need for screening throughout Canada.

Media Contact
Jennifer Paterson
Ottawa Hospital Research Institute
613-798-5555, extension 19691