The PEI Colorectal Cancer Screening Clinical Practice Guidelines have recently been updated, and there are some significant changes starting June 2023 that you should be aware of. One of the most significant changes is the move from two-sample FIT testing to one-sample FIT testing to screen for blood in stool.
This means that the collection device and platform that will be used are now different, and there are new collection requirements. Please find the lab memo below for details.
Colorectal Cancer Screening – Clinical Practice Guidelines 2023 (available on the PDMS website, log-in and search)
Resources Colorectal Cancer Diagnostic Navigation Program
Resources Colorectal Cancer Screening Program
Lab Memo - Change in Fit Collection Device, February 2023PDF
Pink Consent Form / Colonoscopy Referral Form: Call 1-888-561-2233 for delivery
Primary Care Providers
As a primary care provider, you are the first point of access for offering screening to average risk individuals 50 to 74 years of age, and for identifying patients at increased risk. Your role in Colorectal Cancer Screening Program (CCSP) includes:
- Risk assessment: Determining which screening method is right for each patient. FIT screening is the first choice for average risk individuals 50 to 74 years of age. Individuals who are at increased risk, for example those with a first degree member (parent, sibling, child) who have had colorectal cancer should be referred for a colonoscopy at the age of 40 years, or 10 years earlier than the relative’s age at diagnosis, whichever occurs first.
- Testing: Dispensing the program branded FIT kits.
- Ongoing care: Integrating colorectal cancer screening into patient care. A personalized message from a primary care physician to a patient can be the most effective recruitment method to organized screening.
- Talk about it: Discussing colorectal cancer screening with your patients at their next appointment.
- CCSP provides a patient consent form (pink) for participants. A laboratory requisition is not needed for CCSP participants at the ages of 50 to 74.
Fecal immunochemical test (FIT) is available for average risk individuals who are 50 to 74 years old. Primary care physicians play a key role in dispensing CCSP branded FIT kits. Participants can use the kit at home and then drop it off at a hospital laboratory.
Laboratories send all FIT results to primary care providers, and also to CCSP.
CCSP sends letters to participants about their results – normal/negative, abnormal/positive, or incomplete/rejected.
How to obtain CCSP Fecal Immunochemical Test (FIT) kits
Primary care providers (family physicians and nurse practitioners) can order CCSP FIT kits from the CCSP office below.
Check your current inventory of FIT kits to ensure that they are not expired or about to expire.
CCSP office – Four Neighborhoods Health Center, 152 St. Peters Rd, Charlottetown, PE, C1A5P8
Kits can be ordered by phone 902-368-5901, toll-free by phone 1-888-561-2233, by fax 902-368-6936 or email firstname.lastname@example.org
Primary care providers refer individuals with an abnormal/positive result or with an increased risk for colorectal cancer for a colonoscopy. Individuals who are at increased risk can be for example those with a first-degree family member (parent, sibling, or child) who have had colorectal cancer. In this case, individuals can be referred for a colonoscopy at the age of 40 years, or 10 years earlier than the relative’s age at diagnosis, whichever occurs first. CCSP can provide a Colonoscopy Referral Form.
Colorectal Diagnostic Navigation – Colonoscopy assessment
Since August 29, 2022, the screening program has piloted a Colorectal Cancer Diagnostic Navigation Program.
The navigation team directs and supports participants of the Colorectal Cancer Screening Program (CCSP) with a positive Fecal Immunochemical Test (FIT) by providing telephone health assessments, bowel prep and procedure information, and a colonoscopy appointment if appropriate. One goal of the pilot is to meet the national target of having a colonoscopy procedure within 60 days of a positive fecal test result.
Primary care providers continue to receive FIT results from the Provincial Laboratory Services for Colorectal Cancer Screening Program (CCSP) participants. However, they will no longer need to refer CCSP participants who tested positive for blood in stool to an endoscopist for a follow-up colonoscopy.
Following a telephone assessment, the navigation team will communicate to the primary care provider the participant's status and if the participant accepted, declined, or was declined navigation for direct colonoscopy.