The NWT just revised its guidance on when to get tested for colorectal cancer – otherwise known as bowel cancer.
This is one of the most common cancers. From 2007 to 2016, colorectal cancer accounted for about one in every five cancer diagnoses in the NWT.
This week, the NWT government rewrote its guidelines for when and how to get tested, which becomes more important the older you get.
We asked the Department of Health and Social Services to explain the changes.
Before we get to the explanation, let’s go through the new recommendations for NWT residents.
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First, figure out whether you are at “average risk” or “increased risk” according to the GNWT’s definitions:
Average risk: If you have no signs or symptoms of colorectal cancer, no personal or immediate family history of it, no genetic syndromes and no inflammatory bowel disease, this is you.
Increased risk: Was a parent, sibling or child diagnosed with colorectal cancer under the age of 60? Have two immediate family members (of any age) had colorectal cancer? This is you.
There is also a special risk category to be aware of if you have a significant family history or longstanding inflammatory bowel disease.
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Once you’ve figured out your risk level, pick the category below that sounds most like you.
Aged younger than 50, average risk
No special guidance. Obviously, if something seems amiss, go get it checked out.
Aged 50 to 74, average risk
Get a Fecal Immunochemical Test every two years. The GNWT calls this a “simple one-and-done, at-home poop test.” Who doesn’t love a one-and-done at-home poop? Go here and scroll down to learn how you get a test.
The results take a couple of weeks.
Aged 75 and up, average risk
You got past 75 and it didn’t get you, and the GNWT is calling that a win.
The territory’s advice reads: “Individuals aged 75 and above are advised to discuss screening options with their healthcare provider to determine the most suitable course of action. Screening is not routinely recommended for individuals beyond the age of 74.”
Aged 40 or up, increased risk
If you’ve got immediate family members who were diagnosed with colorectal cancer after they hit 60, start your at-home poop tests every two years from the age of 40 – or get a colonoscopy every five years. (Talk to your health centre to set one of those up.)
If you have immediate family who were diagnosed with colorectal cancer before they turned 60, go for colonoscopies to be on the safe side. One every five years, starting either at:
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- the age of 40 or
- 10 years before the age your youngest affected relative was when they were diagnosed.
(Pick whichever of those two would come first.)
If you have a family history of colorectal cancer, let your healthcare provider know. They’ll want to talk to you about referring you to an endoscopist, which is a person who for some reason decided that taking videos inside people was the job for them.
Why these changes?
The department told us the new guidelines provide a “more personalized and risk-categorized approach to colorectal cancer screening, based on current evidence and best practices.”
We know – you have no idea what the old guidelines said. We didn’t either, so we asked.
The department said the new guidelines do the following things that the old ones didn’t:
- Introduce an age cut-off for screening unless a healthcare provider says otherwise once you’re past 74;
- Emphasize a “shift toward minimizing potential harms, concentrating on overdiagnosis and overtreatment;”
- Make screening recommendations “based on increasing levels of risk, taking into account family and personal history;” and
- Standardize the two-year interval for an at-home test if you’re 50-74 and at average risk.
For more information, the Cancer NWT website has a section dedicated to colorectal cancer screening.
