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Ontario will lower the starting age for routine colorectal cancer screening from 50 to 45 on July 1, 2026, Cancer Care Ontario guidance posted by Ontario Health says.
The change expands ColonCancerCheck eligibility for average-risk adults to receive a fecal immunochemical test (FIT) every two years; primary care providers may order FITs from July 1 and formal invitation letters will be phased in over two years.
People with a first-degree relative diagnosed before age 60 should begin screening at 40 (or 10 years younger than the relative’s diagnosis), while those with one relative diagnosed at 60 or older will now use FIT biennially instead of immediate colonoscopy.
The policy follows modelling and mounting international evidence of rising early-onset colorectal cancer and mirrors earlier moves by Prince Edward Island, the United States and Australia.
Health officials expect a modest short-term increase in abnormal FIT results and higher demand for colonoscopies, surgeries and pathology but say earlier detection will reduce diagnoses, deaths and long-term system costs and may help address disparities affecting First Nations communities.


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