Colorectal cancer | Quebec remains the only province without a screening program

(Montreal) Colorectal cancer is the second leading cause of cancer death in Quebec and yet the province still does not have an organized and easily accessible screening program. A situation decried by various organizations and experts.

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.

This has the consequence that a large number of cases are detected too late. According to data from the Canadian Cancer Society (CCS), more than half of colorectal cancers are detected at stage 4.

“It makes a big difference to the survival rate,” says CCS Public Interest Advocacy Team Manager David Raynaud.

The Dr Mustapha Tehfe, hematologist-oncologist at the University of Montreal Hospital Center (CHUM) testifies that “almost all” of his patients with a diagnosis of colon or rectal cancer “presented symptoms, when we could have deal with them well in advance”.

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.

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 could possibly obtain a test in CLSCs, but the implementation is slow to materialize.

“The inertia of the system, you cannot even imagine, denounces the Dre Mélanie Bélanger, president of the Association of Gastro-Enterologists of Quebec (AGEQ). Probably we’ll talk to each other again next year and we’ll still tell 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 explained by Mélanie Bélanger, if lesions are detected during the colonoscopy, “we remove the polyps 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.

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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 about iFOBT

On the occasion of Colorectal Cancer Awareness Month, the Canadian Cancer Society is launching the “Let’s Dethrone Colon Cancer” campaign this Wednesday. The objective is to make the population aware of the importance of screening and to talk to their doctor about it.

It is the singer Ludovick Bourgeois who is the face. Her father, singer-songwriter Patrick Bourgeois, died of colon cancer in November 2017.

This campaign is in addition to the Colorectal Cancer Canada campaign launched earlier this week.

The Dr Mustapha Tehfe laments the fact that too few of his patients diagnosed with colorectal cancer were aware of the existence of the screening test.

The Canadian Press health content gets funding through a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for editorial choices.

“And those who know about the test didn’t know where to go because they don’t have a family doctor,” he laments.

The 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.”

Pending the deployment of a real organized program of systematic sending of invitations to be tested, several stakeholders are demanding easier access to the test, whether through their pharmacist or their CLSC.

The Canadian Press health content gets funding through a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for editorial choices.

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