Ontario Lowers Colorectal Cancer Screening Age to 45, Joining Prince Edward Island in Landmark Policy Shift
Key Insights
Ontario will lower the colorectal cancer (search) screening eligibility age from 50 to 45 for average-risk individuals, effective July 1, 2026, opening screening access to over one million more Ontarians.
The policy also reduces the screening age for those at increased risk to 40, or 10 years before the youngest age a first-degree relative was diagnosed, whichever comes first.
The decision follows rising colorectal cancer (search) incidence in adults under 50 and aligns with guidance from the Canadian Cancer Society (search) and clinical experts.
Ontario is set to become the second Canadian province to lower the colorectal cancer (search) screening age for average-risk individuals from 50 to 45, a policy change that takes effect July 1, 2026. The decision, celebrated by the Colorectal Cancer Resource & Action Network (search) (CCRAN), follows Prince Edward Island's historic move as the first province to adopt the lower threshold and marks what advocates describe as a life-saving step forward in cancer prevention.
"Ontario's decision to lower the colorectal cancer (search) screening age to 45 is an extraordinary victory — not only for advocates, but for every Canadian whose life may be saved," said Filomena Servidio-Italiano, President & CEO of CCRAN. "We have seen too many people diagnosed at advanced stages, facing difficult treatments, when earlier detection could have changed everything."
The policy shift opens the door for more than one million additional Ontarians to access screening services sooner. When colorectal cancer (search) is detected early, nine out of every 10 people with the disease can be cured, according to The Ottawa Hospital. Screening can identify changes before symptoms appear, when treatment is most effective.
Rising incidence in younger adults drives urgency
The epidemiology of colorectal cancer (search) is shifting. Across Ontario, Canada, and many countries worldwide, there has been a notable increase in colorectal cancer incidence among people younger than 50. Colorectal cancer is now considered the deadliest cancer for those under 50 in Canada, yet it remains the most preventable cancer and is highly curable when detected early.
"Colon cancer screening is particularly effective and it reduces deaths due to colorectal cancer (search)," said Dr. Catherine Dubé, Chief of the Division of Gastroenterology at The Ottawa Hospital. "Because it's a very slow-growing cancer, if we catch it early, it's more curable as we can change the natural history of it. As we start to screen earlier, we will reduce the number of deaths from colorectal cancer in young people, but also decrease the number of cases and deaths from colorectal cancer in older people that we're currently screening."
Ontario's move aligns with guidance from the Canadian Cancer Society (search), which has endorsed lowering the screening age to 45 in response to rising colorectal cancer (search) rates among younger adults.
Updated risk-based screening criteria
Beyond the change for average-risk individuals, Ontario's updated screening guidelines include important modifications for those at increased risk. The eligibility age for this group has been lowered from 50 to 40, or 10 years earlier than the youngest age a first-degree relative was diagnosed with colorectal cancer (search) — whichever occurs first.
An individual is considered at increased risk if they have one first-degree relative — a parent, sibling, or child — diagnosed with colon cancer before age 60, or two or more first-degree relatives diagnosed at any age. For these individuals, screening with colonoscopy is recommended every five years.
Screening access and the FIT kit
For most average-risk individuals, colorectal cancer (search) screening does not require a colonoscopy. The fecal immunochemical test (FIT) is a simple, at-home test that checks stool for tiny amounts of blood, which can be caused by colorectal cancer or pre-cancerous polyps. The kit is mailed directly to the home, takes only minutes to complete, and is returned to the lab in a postage-paid envelope. As of July 1, kits can also be dropped off at any Rexall Pharmacy.
Ontarians can obtain a free FIT kit through their family doctor or nurse practitioner. Those without a primary care provider can access the kit through Health811 by dialing 811 or using its live chat function, or through The Ottawa Hospital's Champlain Screening Outreach Program. Once individuals turn 45, screening with the FIT kit is recommended every two years.
National momentum builds
CCRAN has been advocating for the screening age reduction since 2020, convening national symposia on early age onset colorectal cancer (search), engaging policymakers across the country, and amplifying patient voices. Following Prince Edward Island's historic announcement and now Ontario's decision, the organization is calling on all remaining Canadian provinces and territories to follow suit.
"The momentum is building, and we now call on every remaining province and territory in Canada to act with the same urgency and follow their example," said Servidio-Italiano.