Prince Edward Island provincial legislature building in Charlottetown. The province is set to become the first to reduce the colorectal cancer screening age to 45 from 50.Giordano Ciampini/The Canadian Press
Prince Edward Island will become the first province to lower the starting age for colorectal cancer screening to 45 from 50, a move meant to counter rising rates of the disease among younger patients.
PEI Health Minister Cory Deagle announced the change Monday afternoon. The plan takes effect immediately and will see Islanders 45 to 50 eligible to request stool test kits in the mail, just as their peers in the 50-to-74 age bracket have for years.
“I think if we can catch it early, it’ll make a huge difference and hopefully save lives,” Mr. Deagle said in an interview before the announcement.
Cancer advocacy groups hope PEI’s eligibility expansion starts a trend.
Colorectal Cancer Canada called for an earlier start to screening across the country last June, while the Canadian Cancer Society launched a national campaign for the change this month.
Both groups were motivated by a disquieting divergence in rates of new diagnoses of colorectal cancer. Rates have been falling among Canadians 50 and over because screening with fecal immunochemical tests has led to more colonoscopies where precancerous polyps are spotted and removed, preventing cancer.
The opposite is true for people too young to qualify for screening. Between 2001 and 2021, rates of new colorectal-cancer diagnoses rose by 3.7 per cent for Canadians 35 to 39, 2.6 per cent for those 40 to 44, and 1 per cent for those 45 to 49.
Brandon Purcell, advocacy manager of prevention and early detection at the Canadian Cancer Society, predicted PEI’s move would spur other Atlantic provinces to follow suit.
“When one of them makes the move, the others tend to follow pretty keenly,” he said. “We’re hoping for some momentum from this.”
In Nova Scotia, the Liberal opposition tabled a bill last week calling for the screening age to be reduced to 45 from 50. The province’s Health Minister, Michelle Thompson, wouldn’t commit to backing the bill, but told reporters her department is looking into the issue.
Colorectal cancer is the fourth-most commonly diagnosed type of cancer in Canada. But it causes the second-highest number of deaths, after lung cancer, according to the most recent edition of Canadian Cancer Statistics, a major report published last November by the Canadian Cancer Society, the Public Health Agency of Canada and Statistics Canada.
The report’s authors estimated that 9,100 Canadians would die of colorectal cancer in 2025.
The report also noted the increase in rates of new diagnoses among patients younger than 50, a phenomenon it attributed not just to a lack of access to screening.
The rise in colorectal cancer rates “may reflect increases in poor diet, sedentary lifestyle and obesity rates in post-baby boomer generations,” according to the report.
The most common argument against earlier screening for colorectal cancer is that it would drive up costs and add pressure to an already strapped public health system. Stool tests are relatively inexpensive, but they lead to more colonoscopies, which can increase demand for staff and equipment.
Mr. Deagle said PEI predicts the change would cost just $60,000 more a year because of the province’s small population. Officials expect to mail out an additional 1,500 to 2,000 stool tests and perform between 150 and 200 more colonoscopies than usual over the next 30 months, he added.
PEI is expanding screening eligibility just as the federal government prepares to resurrect a task force that provided national guidelines on preventive health measures, including cancer screening, before it was shut down amid controversy last year.
The task force took heat for declining to lower the recommended starting age for mammograms to 40 from 50. Nevertheless, several provinces have since lowered the breast cancer screening age or announced their intention to do so.
The federal task force last weighed in on colorectal cancer screening in 2016, when it recommended that screening for average-risk Canadians not begin until age 50.
The United States and Australia have both since lowered their recommended starting age to 45, while most of Canada’s other peer countries still advise starting at 50.