According to figures from the Department of Health, 2,550 people die each year from colon cancer in Quebec. Despite everything, you still have to go through a doctor or a specialized nurse practitioner (SNP) in order to obtain a prescription to take a screening test.
The immunochemical fecal occult blood test (iFOBT) is easily done at home. This is a simple stool sample. The sample is then deposited in a collection center for analysis. If there is blood present, the patient is then asked to undergo a colonoscopy, where a doctor will examine the condition of their colon.
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In most Canadian provinces, all you have to do is request a kit by phone or email to perform the iFOBT test yourself. The result is then communicated directly to the person who will be directed to the right resources if needed.
Current recommendations state that a person should have this test every two years between the ages of 50 and 74.
The Ministry of Health and Social Services says it is working on setting up a systematic screening program modeled on the breast cancer prevention model. The National Institute of Excellence in Health and Social Services (INESSS) has already determined a procedure according to which people might possibly obtain a test in CLSCs, but the implementation is slow to materialize.
“The inertia of the system, you cannot even imagine, denounces Dr. Mélanie Bélanger, president of the Association of Gastro-Enterologists of Quebec (AGEQ). We will probably talk to each other once more next year and we will still say to each other that things are progressing.
But time can make all the difference. According to data from the Canadian Cancer Society, if the diagnosis falls in the first two stages of the disease, the survival rate is 90%. If it occurs in stage 4 of the disease, the survival rate drops to 11%.
But it gets even better, because colorectal cancer can be avoided altogether. As Dr. Bélanger explains, if lesions are detected at the time of the colonoscopy, “the polyps are removed and you won’t have cancer”.
Thus, in addition to avoiding a possible death, we even prevent having to treat a patient. At the same time, they are spared unpleasant treatments and the burden on the health system is reduced.
However, the deadlines also have to be taken into account. Before the COVID-19 pandemic, the waiting list for a colonoscopy in Quebec was 59,000 people, while today it has grown to 135,000 people.
At the same time, the rate of waiting patients who exceeded the prescribed time to undergo their examination rose from 45% to 69%, according to data provided by the AGEQ.
Raising awareness regarding iFOBT
On the occasion of colorectal cancer awareness month, the Canadian Cancer Society is launching the campaign “Let’s dethrone colon cancer” this Wednesday. The objective is to make the population aware of the importance of screening and to talk to their doctor regarding it.
It is the singer Ludovick Bourgeois who is the face. Her father, singer-songwriter Patrick Bourgeois, died of colon cancer in November 2017.
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This campaign is in addition to the Colorectal Cancer Canada campaign launched earlier this week.
Dr. Mustapha Tehfe, hemato-oncologist at the University of Montreal Hospital Center (CHUM), deplores the fact that too few of his patients who have been diagnosed with colorectal cancer were aware of the existence of the screening test.
“And those who know regarding the test didn’t know where to go because they don’t have a family doctor,” he laments.
Dr. Tehfe, who is also a full professor in the Department of Medicine at the University of Montreal, promises to continue working so that the screening program becomes routine for all people aged 50 and over.
“People need to know where to go and how to get a test,” he insists. Unfortunately, right now in Quebec, you have to go through a doctor.
