Quebec remains the only province without a colorectal cancer screening program

This microscope image made available by the National Cancer Institute Center for Cancer Research in 2015 shows human colon cancer cells with the nuclei stained red. THE CANADIAN PRESS/NCI Center for Cancer Research via AP

Colorectal cancer is the second leading cause of cancer deaths in Quebec, yet the province still doesn't have an organized and easily accessible screening program.

It's a situation decried by various organizations and experts.

According to figures from the Health Ministry, 2,550 people die each year from colon cancer in Quebec. Despite this, it's still required to go through a doctor or a specialized nurse practitioner to obtain a referral for a screening test.

The fecal occult blood test (FOBT) involves taking a stool sample and is easily performed at home. The sample is taken to a collection center for analysis. If blood is present, the patient is directed to undergo a colonoscopy, where a physician will examine the condition of the colon.

In most Canadian provinces, you can request a kit by phone or email to perform the FOBT test yourself. The results are then communicated directly to you, followed by a referral to the appropriate resources if needed.

Current guidelines recommend individuals be tested every two years between the ages of 50 and 74.

Quebec's Health Ministry says it's working on a systematic screening program modelled on breast cancer prevention. The Institut national d'excellence en santé et en services sociaux (INESSS) has already determined a procedure whereby patients could obtain tests through local clinics (CLSCs), but the implementation is slow to materialize.

"You can't even imagine the inertia of the system," says Dr. Mélanie Bélanger, gastroenterologists' association (AGEQ). "We'll probably talk again next year and say that things are moving forward."

But time can make all the difference. According to the Canadian Cancer Society, if the diagnosis is made in the first two stages of the disease, the survival rate is 90 per cent. If it occurs in stage four of the disease, the survival rate drops to 11 per cent.

But colorectal cancer can be prevented altogether. As Dr. Bélanger explains, if lesions are detected at the time of the colonoscopy, "we remove the polyps, and you won't get cancer."

This means that, besides avoiding a possible death, doctors can spare patients from unpleasant treatments and reduce the burden on the health care system.

And there's also the issue of wait times. Before the COVID-19 pandemic, the waiting list for a colonoscopy in Quebec was at 59,000 people, whereas today, it has grown to 135,000.

At the same time, the rate of overdue patients has increased from 45 per cent to 69 per cent, according to data provided by the AGEQ.

RAISING AWARENESS

As part of Colorectal Cancer Awareness Month, the Canadian Cancer Society is launching a campaign Wednesday to raise awareness of the importance of screening.

Singer Ludovick Bourgeois is the face of the campaign. His father, singer-songwriter Patrick Bourgeois, died of colon cancer in November 2017.

Dr. Mustapha Tehfe, a hemato-oncologist at the Centre hospitalier de l'Université de Montréal (CHUM), laments that too few of his patients diagnosed with colorectal cancer were aware of the screening test.

"And those who do know about the test didn't know where to go because they don't have a family doctor," he said.

Dr. Tehfe vows to continue working to make the screening program routine for everyone 50 and older.

"People need to know where to go and how to get tested," he said. "Unfortunately, right now in Quebec, you have to go through a doctor." 

This report by The Canadian Press was first published in French on March 1, 2023.