Dr. Michael Sey, Regional Colon Cancer Screening Lead, South West Regional Cancer Program (SWRCP), and Gastroenterologist and Therapeutic Endoscopist at London Health Sciences Centre (LHSC).
September 11, 2026
As of Wednesday, July 1, 2026, eligible Ontarians at average risk for developing colon cancer can start screening earlier at the age of 45 with fecal immunochemical test (FIT) every two years. This was lowered from 50 years of age due to an increase in younger people being diagnosed with the disease.
Why was the screening age lowered for colon cancer screening?
Dr. Michael Sey, Regional Colon Cancer Screening Lead, South West Regional Cancer Program (SWRCP), and Gastroenterologist and Therapeutic Endoscopist at London Health Sciences Centre (LHSC) confirms that the main reason behind this change is that there is an increase in younger people being diagnosed with the disease.
"Based on newer research, we can see the risk of colon cancer varies based on the generation you were born into," Dr. Sey explains. "For example, those born in the 1980s appear to have colon cancer rates double those born in the 1950s, with the risk climbing among younger generations."
While colon cancer is still predominantly a disease diagnosed after 50, there has been growing concern as younger patients are getting diagnosed more often.
"There are more people diagnosed in their 40s now, but the percentage of cancer cases in younger patients is still smaller than the number of patients diagnosed over the age of 50. Right now, about 10-15 per cent of patients diagnosed with colon cancer are younger than 50, mostly in their 40s. But that is still concerning and higher than we have historically seen," shares Dr. Sey.
What does this shift in screening age mean for Ontarians?
"The provincial colon cancer screening program, ColonCancerCheck, automatically identifies individuals due for screening and mails them an invitation letter to encourage them to screen for colon cancer, but you do not have to wait to get a letter to see your primary care provider about getting screened," says Dr. Sey. "As of July 1, if you are 45 years old and are eligible for screening, you can make an appointment with your primary care provider and ask them to order you a FIT kit. I'm 45 and already made an appointment with my doctor!"
What is the FIT?
The FIT is a test that screens for colon cancer by checking your stool (poop) for tiny amounts of blood which can be caused by colon cancer or some types of polyps (abnormal growths on the lining of the colon or rectum that could turn into cancer over time). This test only takes a few minutes, is painless, and can be done in your own home.
You can get your FIT kit by asking your family doctor or nurse practitioner to order one for you. If you do not have a family doctor or nurse practitioner, you can contact Health811 by dialing 811 (TTY:711). Once a FIT kit has been ordered for you, In-Common Laboratories will mail a FIT kit to an Ontario mailing address of your choice.
How does the FIT work?
The FIT comes in a small, plastic tube with the supplies needed to collect your stool sample.
You prepare by checking that your name and date of birth are correct on the tube before preparing the toilet to collect your stool sample.
It is important to urinate and flush first before putting the collection paper in the toilet bowl.
You collect the stool sample by taking the lid off the plastic tube and using the stick attached to the lid to take a sample and put it back in, sealing the top of the tube.
Then you just mail or drop off your completed FIT within two days of doing it. If you plan to mail your FIT, please be aware of any mailing delays, such as long weekends. You can also drop your completed FIT at any Ontario Rexall location. A list of Ontario Rexall locations is available at iclabs.ca/locations.
You can find full, detailed instructions in multiple languages on the Cancer Care Ontario website.
Are there going to be longer wait times to receive the test, receive the results, or receive follow-up as a result of Ontario lowering the age for screening?
"There are two parts to the screening process," explains Dr. Sey. "The FIT itself – which is the screening test – and then a colonoscopy, which is the second stage if the FIT shows an abnormal result."
Dr. Sey notes that Ontario has done a lot of work to make sure that the lab that supports the FIT has capacity for larger volumes of submitted tests.
The same is true for colonoscopy units across the province.
"Hospitals and endoscopy units have been preparing for this change for many months now to avoid delays in getting a colonoscopy if you have received an abnormal FIT result," says Dr. Sey.
What happens if a person receives an abnormal FIT result?
If a person receives an abnormal FIT result, that does not necessarily mean they have colon cancer or polyps.
"The FIT checks for the presence of blood in a person's stool and casts as wide a net as possible, which will inevitably capture people who do not have cancer and could have something else such as polyps" Dr. Sey shares. "After an abnormal result, the next step would be to schedule a colonoscopy appointment as soon as possible to determine the potential cause of the blood in the stool and whether it is cancer."
How does someone know if they are considered increased risk for colon cancer?
As of July 1, 2026, someone is at increased risk if they have:
- one first-degree relative (parent, sibling, child) diagnosed with colon cancer before age 60, or
- two or more first-degree relatives diagnosed with colon cancer at any age.
ColonCancerCheck recommends that people at increased risk of getting colon cancer should screen with a colonoscopy every five years, starting at age 40, or 10 years earlier than the youngest age a relative was diagnosed with colon cancer (whichever comes first).
What are common symptoms of colon cancer?
Some common colon cancer symptoms, as noted by the Canadian Cancer Society include (but are not limited to):
- diarrhea
- constipation
- stool (poop) that looks narrower than usual
- feeling like the rectum is not completely empty after a bowel movement
- bright or very dark red blood in the stool
- bleeding from the rectum
- gas, abdominal cramps and feeling bloated
- pain or discomfort in the rectum
- a lump in the abdomen or rectum
- fatigue and weakness
- anemia
- nausea and vomiting
- loss of appetite
- weight loss
However, Dr. Sey cautioned that many patients with colon cancer do not have symptoms.
Should people get screened even if they don't have symptoms?
"Absolutely. Screening is for people who don’t have symptoms, if you have symptoms, the FIT would not be an appropriate test," explains Dr. Sey. "If you have symptoms, you should see your doctor to figure out what the symptoms are from."
Dr. Sey shares that it may seem counterintuitive, but screening is to capture people who don't have symptoms of colon cancer. “We want to diagnose colon cancer early, well before there are symptoms, so that it can be treated”, says Dr. Sey.
Dr. Sey's final words on colon cancer screening
"Get screened if you are due. Colon cancer is preventable and treatable when caught early. The FIT is painless, easy, and can be done at home," Dr. Sey notes. "If you have a family doctor or nurse practitioner, you can ask them to order a free ColonCancerCheck FIT kit for you. If you don't have a family doctor or nurse practitioner,, you can contact Health811 to get your free ColonCancerCheck FIT kit."
You can find more information about colon cancer screening on the Screening for Colorectal Cancer section of the Cancer Care Ontario website.