HEALTH CARE
Early results
in the screening process for colorectal cancer
Submitted by B.J. Lawlor, MB. BCh. FRCS(C), Medical Advisor SPCRC, Saskatchewan Cancer Agency; Annamae Perry, MLT ART,
Manager SPCRC, Saskatchewan Cancer Agency; Sabuj Sarker,
M.Sc., Research Officer-Epidemiologist, Epidemiology and Performance Measurement, Saskatchewan Cancer Agency
The Screening Program for Colorectal Cancer (SPCRC) is a
program of the Saskatchewan Cancer Agency. The SPCRC
targets residents aged 50 to 74 years who are asymptomatic. SPCRC uses the human-specific Fecal Immunochemical
Test (FIT) to look for occult blood in the stool. The program
began in the Five Hills Health Region in 2009 and completed province-wide expansion in 2013.
Since January 2013, the FIT has been available outside the
SPCRC for opportunistic screening primarily for patients
<50 and >74 years of age. The FIT has largely replaced FOBT,
and does not require any dietary or medication restrictions.
In some health regions (as shown in Figure 1), SPCRC client
navigators are able to navigate patients with abnormal results to colonoscopy with a primary care practitioner (PCP)
signed medical directive. The navigators, who are experienced endoscopy nurses, speak directly with patients to
explain the procedure, address any concerns, optimize the
bowel preparation and alert the PCP and the endoscopist
to specific problems such as anticoagulation, diabetes, etc.
Patients who are navigated are shown to be much better
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SMA NEWS DIGEST | SUMMER 2014
informed regarding colonoscopy. The client navigation program will expand to be province-wide and also available to
patients who are screened opportunistically, provided they
lie within the SPCRC age range. In some health regions, particularly the larger regions, navigation and pooled referrals
have significantly reduced the time from a positive FIT to
colonoscopy.
Figure 1: Expansion of SPCRC client navigation
Legend
Navigation in place
Discussion in progress
with working groups
established
Initiating discussions
Key steps
Target is for FIT+ clients in
all regions to have access
to client navigation by
the screening program for
colorectal cancer
•
5 of 13 regions are
being navigated
•
Discussions in progress with Kelsey Trail,
Five Hills, Heartland,
Cypress, and northern regions (Athabaska, Keewatin
Yatthe, Mamawetan
Churchill