Study finds too many colorectal cancers are found too late

TORONTO — New statistics find almost half of the colorectal cancers in Canada are discovered after they’ve already spread, even though most provinces and territories have screening programs that can catch it in early stages.

The report by the Canadian Cancer Society says about 29 per cent of colorectal cancers are diagnosed at stage 3, and 20 per cent are diagnosed at stage 4.

That has the society urging those between the ages of 50 and 74 who are not high risk to get tested every two years. They point to an at-home stool test can even detect pre-cancerous signs.

One of the report’s authors, Dr. Leah Smith, says early detection is key to boosting survival rates but relatively few seem to be taking advantage of organized screening programs.

The five-year survival rate when diagnosed at stage 4 is less than 15 per cent. The rate increases to 90 per cent when it is found at stage 1.

Wednesday’s study was gathered in partnership with the Public Health Agency of Canada and Statistics Canada.

“We have the tools available to detect these cancers earlier. Unfortunately, what we’re also seeing is that participation in colorectal cancer screening is lower than we need it to be to really make a move on this cancer,” says Smith, senior manager of surveillance at the Canadian Cancer Society.

“Early detection for this disease is key.”

Nine provinces and the Yukon currently have organized colorectal cancer screening programs that use at-home stool tests, and plans are underway to develop programs in Nunavut and Quebec. Northwest Territories does not have an organized screening program but stool tests are available through hospitals and clinics.

Smith says Canadians aged 50 to 74 years of age, about one third of the population, should be screened, but researchers found less than 60 per cent of the people eligible are doing so.

Singer-songwriter Jeff Orson says he can’t help but urge those around him to get tested after he was diagnosed with stage 2 colorectal cancer.

“How could you not go; how can you not do this? If it’s in your family, especially, you’re at risk, it’s easily preventable,” says the 56-year-old performer, based in Oakville, Ont.

He was lucky to catch it early when he went to his doctor complaining of insomnia. A stool test led to more tests including a colonoscopy, and the discovery of a tumour in his colon.

“That was one of the most horrible things I ever heard in my life: ‘You have cancer and we don’t know what your future holds for you,’” Orson recalls.

Surgery removed 18 centimetres of his colon and he’s been cancer-free four years.

Now he does regular colonoscopies and blood tests and doesn’t shy away from sharing his story on his website, and onstage during performances.

“It’s like a shadow, it never kind of leaves you,” he says. “I don’t dwell on it a lot but everyday I’m thankful that I get up.”

Colorectal cancer is the second most commonly diagnosed cancer in Canada and the second leading cause of cancer death, after lung cancer.

It is estimated that about 1 in 13 men and 1 in 16 women will be diagnosed with colorectal cancer during their lifetime.

An estimated 26,800 Canadians were diagnosed with colorectal cancer in 2017, representing 13 per cent of all new cancer cases, while 9,400 Canadians died from the disease, representing 12 per cent of all cancer deaths.

Simply put, fewer Canadians would die from this disease if more were screened, says Smith.

She notes that more than 80 per cent of breast cancers are found at stage 1 or 2, likely due to screening. As a result, breast cancer survival rates are 87 per cent compared to lung cancer, which are closer to 17 per cent. About half of lung cancers are found at stage 4.

“It really helps reinforce that connection between early detection and survival.”