Canada Moves to Catch Cancer Earlier: Provinces Push to Lower Colorectal Screening Age to 45

A quiet but significant shift is taking shape across Canada. One province and one territory have already committed to lowering the colorectal cancer screening age from 50 to 45, and several others are now seriously weighing the same move a change that advocates say could save countless lives and spare families the kind of suffering that has defined too many Canadian households.

Prince Edward Island made the announcement earlier this week, becoming among the first provinces to formally lower the screening threshold. Nunavut confirmed to Global News on Tuesday that it, too, is moving in the same direction. Meanwhile, BC Cancer said it is actively investigating a similar adjustment, with data modelling currently underway.

“While younger adults have a lower risk of colorectal cancer compared to older adults, emerging evidence has prompted BC to investigate lowering the starting age for screening,” said Dr. Fabio Feldman of BC Cancer.

For Barry Stein, CEO of Colorectal Cancer Canada, the news is a long time coming.

Stein was just 41 years old when he was diagnosed with colorectal cancer in 1995. He had noticed symptoms but, like many, pushed them aside. By the time doctors confirmed what was wrong, the cancer had already spread to other parts of his body. What followed were four liver surgeries in New York, chemotherapy in Canada, and an experimental vaccine trial in California a gruelling ordeal that reshaped his life entirely.

“We don’t want people to have to go through what I went through, which was a very traumatic, costly experience to myself and my family,” Stein said.

That experience eventually led him to found what is now Colorectal Cancer Canada, and more recently, to launch a national ‘Screen at 45’ campaign pushing every province and territory to lower eligibility. The campaign has been gaining ground.

Nova Scotia, New Brunswick, Alberta, and Saskatchewan have each told Global News they are reviewing recommendations. Saskatchewan’s ColonCheck program is specifically assessing the evidence and timeline required to reduce the eligibility age. Manitoba, Quebec, the Northwest Territories, and Newfoundland and Labrador said they are continuing to review the evidence, though no changes are imminent. Ontario, meanwhile, confirmed it is exploring ways to strengthen cancer care but stopped short of signalling any specific plans.

The push is being driven, in large part, by a troubling trend in the data. According to the Canadian Cancer Society, people under 50 are now two to two-and-a-half times more likely to be diagnosed with colorectal cancer than previous generations were at the same age.

Dr. Enrique Sanz Garcia, a clinical investigator at the Princess Margaret Cancer Centre in Toronto, said those figures reflect what he sees daily in his clinic.

“This is something that we are seeing more often at this point,” he said, adding that while the exact causes remain unclear, risk factors such as diets high in ultra-processed foods and sedentary lifestyles are associated with the disease. Even so, he stressed that many patients he treats have none of those markers at all.

That unpredictability, he argued, is precisely why earlier, broader screening matters.

Current Canadian guidelines recommend that adults with average risk and no symptoms begin screening between the ages of 50 and 75, typically using a fecal immunochemical test a simple at-home kit that checks for traces of blood in the stool. A positive result doesn’t automatically mean cancer is present, but it does signal that a follow-up colonoscopy is warranted.

Sanz Garcia noted that the majority of colorectal cancer cases his team catches are found not because patients came in with alarming symptoms, but because they showed up for routine screening with no symptoms at all.

“The reality is that most of the people that we are seeing in the clinic, they are caught by a screening,” he said. “They are caught asymptomatic.”

Common warning signs to watch for include rectal bleeding, unexplained shifts between constipation and diarrhea, abdominal pain, and sudden weight loss though the absence of these symptoms is no guarantee of a clean bill of health.

For Stein, the momentum building across the country feels personal. He acknowledges that even a screening program starting at 45 wouldn’t have caught his cancer when it mattered most for him. But he believes it would have changed the awareness landscape in a way that might have led him, and others like him, to act sooner.

“We really want to save lives,” he said. “That is the purpose of doing it.”