CancerCare Manitoba - CRCSP - Frequently Asked Questions

Frequently Asked Questions

Tools:	Text Smaller		Text Larger
	Email a Friend		Print

Updated February 2012

Using the Home Screening Test

Your Test Result

68. How will I get my test results?
69. Who else gets my test results?
70. What does it mean if I have an abnormal result?
71. If I completed the home screening test and the result was normal, is there any chance I could still have cancer or polyps?
72. If colon cancer develops so slowly, why screen every two years?

Colonoscopy

73. What is a colonoscopy?
Top

Colon Cancer and Polyps

1. What is the colon and what does it do?

The colon is about six feet long and is the part of the body's digestive system that moves waste material from the small intestine to the rectum.
Together the colon and the rectum make up the large intestine also known as the bowel.
The small intestine absorbs most of the nutrients out of what you eat and then passes on the leftover waste to the colon. The colon absorbs water from the waste. What is left is called stool (feces or poop). When you have a bowel movement, the stool leaves the rectum through the anus.

Enlarge

2. What causes colon cancer?

Age is the greatest risk factor for colon cancer. 94% of the cases occur in men and women over the age of 50.
Other factors that may increase your risk include:
- A personal history of polyps or Inflammatory Bowel Disease (ulcerative colitis or Crohn's disease).
- A strong family history, such as:
  - 2 close family members (mother/father, sister/brother, son/daughter) who had colon cancer or polyps or
  - 1 close family member who had colon cancer or polyps before age 60.
- Lifestyle choices about your diet, exercise, alcohol and tobacco use.

3. What are polyps?

Irritable Bowel Syndrome (IBS), not to be confused with Inflammatory Bowel Disease, is a condition caused by the muscles in the colon wall. IBS is characterized by alternating bouts of diarrhea and constipation, abdominal cramping, bloating, and frequent bowel movements shortly after eating. IBS is diagnosed by first eliminating the possibility of more serious causes of these symptoms. Although IBS may be distressing, it does not increase your risk of colon cancer.
Inflammatory Bowel Disease (IBD) may put you at an increased risk of colon cancer. IBD is a general term to describe conditions that cause the colon and rectum to become inflamed. There are 2 characteristic patterns of inflammation, one called ulcerative colitis and the other named Crohn's disease. For more information about IBD, click here.

3. What are polyps?

Polyps are small growths that can develop in many parts of the body including the colon and rectum.
Polyps can bleed into the colon or rectum.
Polyps are often shaped like a mushroom. They may be as small as a pea or as large as a plum.
Some polyps can turn into cancer if they are not removed.

5. Do hemorrhoids cause colon cancer?

No. Hemorrhoids, or piles, are one of the most common and nagging disorders. By themselves, hemorrhoids are rarely serious, but they can be extremely troublesome. In some instances, they may mask a more serious disorder, such as colon or rectal cancer. Therefore, hemorrhoids require the proper diagnosis and treatment by a physician.

6. How do most colon cancers start?

Most colon cancers start as polyps. But most polyps do not become cancerous.

7. What are the symptoms of colon cancer?

There are often no symptoms in the early stages, when the disease is most treatable.
Symptoms of colon cancer may include:
- Rectal bleeding, or any sign of blood after bowel movements
- Unexplained weight loss, tiredness or exhaustion
- Persistent change in bowel habits such as:
  - Diarrhea or constipation for more than a few weeks
  - Stools that are consistently more narrow than usual
  - The feeling that you are not completely emptying your bowel

8. Can people under 50 years of age get colon cancer?

Yes, but people under 50 do not usually get colon cancer. In Manitoba, 94% of newly diagnosed colon cancer occurs in people over the age of 50. However, there are hereditary syndromes in which cancer can develop in young people. The first is Familial Adenomatous Polyposis (FAP). The other inherited disorder is hereditary non-polyposis colorectal cancer (HNPCC). Persons with a strong family history of colon cancer may have other unidentified genetic factors which contribute to the development of colon cancer. If you know someone in your family who has either FAP or HNPCC, talk to your doctor or nurse as you may be at increased risk.

9. What is Familial Adenomatous Polyposis (FAP)?

This disease is associated with a gene mutation. People with FAP develop hundreds to thousands of precancerous polyps in the colon. Unless the colon is removed, almost all of these people will eventually get colorectal cancer. The polyps usually develop in the mid-teens, but they have been found in children as young as eight. For families with FAP, there is a genetic test available to screen for the gene mutation. Screening can begin early and surgery to remove the colon can be planned. If you know someone in your family who has either FAP or HNPCC, talk to your doctor as you may be at increased risk.

10. What is hereditary non-polyposis colorectal cancer (HNPCC)

In this syndrome, cancers also develop from polyps but not in the hundreds as in FAP. The cancers usually develop in middle age (late 30's-mid 40's). In addition to colon cancer, there may also be an increased risk of cancers of the stomach, breast, urinary tract and uterus. Genetic testing may also be helpful in determining whether someone has HNPCC. If you know someone in your family who has either FAP or HNPCC, talk to your doctor or nurse as you may be at increased risk.

11. I am under 50 years of age. Can I develop colon cancer if I do not have FAP or HNPCC?

It is possible, although colon cancer is not common before 50 years of age.
Other environmental and genetic factors may contribute to the development of colon cancer at an earlier age.

12. Are there different types of polyps?

Yes, there are many different types of polyps. Some can develop into cancers, while others will not.
Adenomatous and villous polyps are considered "pre-cancerous" and may grow and develop abnormal cells which can become cancer.
Other polyps, such as hyperplastic or inflammatory polyps, are not pre-cancerous but may exist with pre-cancerous polyps

13. If the polyp is removed, does that mean I am cured?

If a polyp is completely removed, it will not usually grow back. Villous polyps are usually harder to remove completely as they are often flat in shape and closer to the colon wall.
If a polyp contains cancer, a cure will depend on the how far the cancer has advanced and how close the cancer is to the cut portion of the polyp. Follow-up with colonoscopy is usually required to ensure complete removal. Sometimes surgery is required to ensure that all the cancer is removed.

14. Is it possible to have colon or rectal cancer without having polyps?

Colon cancer can occur without polyps but it is less common. Individuals with inflammatory bowel diseases (IBD), such as chronic ulcerative colitis and Crohn's disease, are at increased risk for developing colon cancer without polyps.
The risk of colon cancer increases with the length of time a person has IBD, as well as how much of the colon (bowel) is affected by the IBD.

Top

Colon Cancer Screening

15. What can I do to reduce my risk of colon cancer?

Get screened:
It is recommended that most people ages 50-74 do a home screening test every two years.
Some people may be at increased risk and need colon cancer screening before age 50 or need a different test called a colonoscopy.
Make healthy lifestyle choices:
- Eat well:
  - Eat 7-10 servings of fruits and vegetables each day.
  - Drink alcohol in moderation (no more than 2 drinks/day for men and no more than 1 drink/day for women).
  - Limit the amount of red meat and processed meats that you eat.
- Be physically active for 30 minutes or more per day.
- Maintain a healthy weight
- Don't smoke or use tobacco.

16. What is the home screening test?

The home screening test is also called a Fecal Occult Blood Test, or FOBT. It is a simple test that you do in your own bathroom. You place samples of your stool is on a test card and sent to the lab where it is checked for blood. Blood may be a sign of polyps or colon cancer.

17. What is stool or feces?

Stool or feces are other words used for human excrement, your bowel movement or poop.

18. How can I get a home screening test?

Click here to request a home screening test.
Or talk to your Doctor or nurse about screening. If you do not have a Doctor, call the Family Doctor Connection Line at 786-7111 or 1-866-690-8260. If you would like to contact a Nurse Practitioner please www.nursepractitioner.ca for a list of NP's in Manitoba accepting new patients.

19. What are the benefits of the home screening test?

The home screening test can be done at home. Completing this test and any follow-up test may find polyps or colon cancer is its early stages, when treatment is most effective.
Screening with the home screening test can reduce deaths from colon cancer by up to 25%.

20. What are the risks of the home screening test?

Home screening test alone has little risk or harm.
An abnormal result leads to tests such as colonoscopy that have more risk.
The home screening test is not perfect:
- It may say there is blood when there really is none and this may results in unnecessary further testing.
- It may miss blood in a sample and possibly miss a diagnosis of polyps or cancer.
Some polyps and colon cancers do not bleed. Therefore, the home screening test will not detect all polyps or cancer.

Top

ColonCheck

21. What is ColonCheck?

CancerCare Manitoba, with funding from Manitoba Health, established the Manitoba Colorectal Cancer Screening Program in April, 2007. The name of the screening program changed to ColonCheck in August 2009. The goal of the program is to reduce the number of Manitobans who die from colon and rectal cancers. The program is inviting people between the ages of 50 & 74 to be screened for colon cancer.

22. How do I contact the Program?

Phone: (204)788-8635
Toll Free: 1-866-744-8961
Mailing Address: 5-25 Sherbrook St. Winnipeg, MB R3C 2B1
Email: coloncheck@cancercare.mb.ca

23. What resources are available.

We have many resources available for the general public. Click here for a listing.
Health educators may also be available to do presentations to groups. To request a presentation at an event or health fair, contact us 788-8635 or 1-866-744-8961.

24. How did you get my address?

We are a program funded by Manitoba Health. Manitoba Health has given CancerCare Manitoba the names and addresses of people ages 50 to 74. We also get billing data that tells us who has had a colonoscopy in the last 5 years or a home screening test in the last 2 years.

25. Why do you test for colon cancer in people who don't have any symptoms?

When cancer is in its early stage, most people don't have any symptoms. The earlier polyps or colon cancer are found, the more successful the treatment.
Colon cancer develops slowly. It can take up to 10 years for a precancerous polyp to develop into cancer.

26. Why are only people 50-74 years of age invited to participate in ColonCheck Manitoba?

For people under 50 and over 74 years of age, screening depends on the person's health and family history. All Manitoba residents have access to screening for colon cancer. We encourage you to discuss colon cancer risk factors and screening options with your doctor or nurse.

27. How can I get screened for colorectal cancer?

You can do one of the following:
- Click here to request a kit online.
- 1-866-744-8961 to request a home screening test. We will ask you a few questions to see if it is time to get screened.
- Or talk to your health care provider about screening.
- Most people age 50 and older should complete a home screening test every two years.
- Some people may be at increased risk and need colon cancer screening before age 50, or need a different test called a colonoscopy.

28. What if I have had a colonoscopy within the past 5 years?

Since you have already had a colonoscopy, you are already screened and do not need to do a home screening test at this time. A colonoscopy is the test that is recommended after an abnormal home screening test.
As it is a diagnostic test, most people do not need to be screened for 5 years after having a colonoscopy.

29. What if I have had a sigmoidoscopy or gastroscopy?

You can participate in this screening program. Call ColonCheck at 788-8635 or toll free at 1 (866) 744-8961 to see if you meet the other eligibility requirements, and request a home screening test.

30. What if I have had colon cancer, polyps or an inflammatory bowel disease such as Crohn's or ulcerative colitis?

Do not do this test. You may need to have a colonoscopy instead of the home screening test. If you have these conditions and have questions about if you need a colonoscopy, see your doctor or nurse.

31. What if I have an ostomy?

If you have an ostomy, the home screening test may not be appropriate for you. We recommend that you check with your doctor or nurse and discuss your personal history and what is best for you.

32. What if I would still would like a to do the home screening test, even though I do not meet the criteria for ColonCheck Manitoba?

Please visit your doctor or nurse to discuss if the test is right for you.
If you don't have a Family Doctor, call the Family Doctor Connection Line at 786-7111 or 1-866-690-8260.
To find a Nurse Practitioner please visit www.nursepractitioner.ca for a list of NP's in Manitoba accepting new patients.

33. What if I have completed a home screening test at my doctor or nurse's office?

If you have completed a home screening test in the past two years, do not complete the test but return it to us in the postage-paid envelope. If it has been longer than 2 years, you can do the test.

34. I got the test kit from ColonCheck, and would like to do the test, but I can't do it at this time. Can I keep the test and complete it later?

Yes. If we do not receive a response from you in 6 weeks, you will get a reminder letter as our system is automatically set up to send a reminder at 6 - 8 weeks. Each test has an expiration date on the back. If your test has expired and you would like a new one, call us to mail it out to you.

35. Is it safe to send the completed test in the mail?

Yes, please return it by following the instructions.

Top

Using the Home Screening Test

36. Where can I get an English or French copy of the Instruction pamphlet?

Click here for a copy of the Instruction pamphlet in English.
Click here for a copy of the Instruction pamphlet in French.
If you can't download the file, please call ColonCheck at (204)788-8635 or 1-866-744-8961.

37. Are there any medications that I need to avoid while I'm doing the test?

You can not take most NSAIDs for 7 days before you start the test and until you have completed your samples.
NSAIDs are non-steroidal anti-inflammatory drugs.
NSAIDs can be used as pain relievers. They also help reduce inflammation and lower fevers. Because they reduce clotting action, some NSAIDs, are used as a protective effect against heart disease.
Aspirin® (acetylsalicylic acid) is an NSAID that you can take while doing the test, but not more than 325mg/day.
Some NSAIDs are available over-the-counter in your pharmacy and some require a prescription from your doctor.
Check with your doctor or nurse before you stop taking any drugs that have been prescribed to you.
Click here for a more complete list of NSAIDs.
Some common NSAID's are:
1. ibuprofen (Motrin®, Advil®)
2. naproxen (Naprosyn®, Aleve®)
3. celecoxib (Celebrex®)
4. indomethacin (Indocin®)
5. diclofenac (Voltaren®)

38. Why can't I take NSAIDs or more than 325 mg/day of Aspirin® (acetylsalicyclic acid) while I'm doing the test?

It could affect the accuracy of your test result. These drugs may cause a small amount of bleeding in your stomach that the test may detect, causing a false positive result.

39. Is it OK to take Tylenol® (acetaminophen) while I'm doing the test?

Yes, acetaminophen can be taken during the collection process.

40. Do I need to avoid eating red meat while I'm doing the test?

Yes, you will need to avoid certain meats for 3 days before you start the test and until you have completed the samples. Do not eat red meats such as:
- beef,
- lamb,
- moose,
- deer,
- bison
- or liver.

41. Is it OK to eat pork, ham, chicken, turkey or fish while I'm doing the test?

Yes.

42. Why can't I eat any red meat while I'm doing the test?

If you eat red meat, it could affect the accuracy of your test results. The test may detect the blood in the meat causing a false positive test result.

43. Are there other foods or vitamins that I need to avoid while I'm doing the test?

For 3 days before you start the test and until you have completed your samples, do not eat, drink or take more than 250 mg/day of Vitamin C from foods, drinks or supplements.

44. How much is 250 mg of Vitamin C?

One average-sized orange has approximately 75 mg, so 3 oranges in one day would be your maximum allowed during your collection period. For a complete listing of foods and the content of Vitamin C, click here.

Some common sources of Vitamin C are:

food/drink	mg of Vitamin C
Orange (average size)	75 mg
Orange juice (1 cup)	100 mg
Grapefruit (average size)	80 mg
Grapefruit juice (1cup)	80 mg
Strawberries (1cup)	95 mg
Kiwi (1 average size)	75 mg
Pepper(red or green)raw (1 average size)	65 mg
Broccoli (1 cup)	60 mg
Cantaloupe (¼)	60 mg

45. I have heard that iron supplements sometimes have vitamin C in them. What should I do if I took an iron supplement during the collection process?

Read the label on the bottle to check if there is vitamin C in the brand that you are taking.
If you are unsure, ask your pharmacist.
If you did consume more than 250 mg of Vitamin C, call us for a new test.

46. Why can't I have more than 250 mg/day of Vitamin C while I'm doing the test?

If you consume more than 250 mg/day of Vitamin C the test may not find blood that is in the stool, causing a false negative result

47. What should I do if I do take more than 325 mg of Aspirin® eat or drink more than 250 mg of Vitamin C/day, or eat red meat, during the collection period?

Discard the test and call ColonCheck for a new test at 204-788-8635 or toll free at 1-866-744-8961.

48. Should I start the test if I am menstruating?

Wait until your period is finished before starting the test.

49. What if my menstrual period starts during the collection period?

Call ColonCheck for a new test at 204-788-8635 or toll free at 1-866-744-8961.

50. What if it takes more than 3 days for me to complete the test?

Once you start the test, you must collect and mail the samples within a maximum of 7 days.
7 additional days are needed to account for the time it takes for the lab to receive the mail analyze the test.
If more than 14 days has passed between the day the first sample was collected and the day the test was analyzed, ColonCheck will send you a new test to complete.

51. If I have more than one bowel movement in a day, can I take samples from each of them?

Because polyps and cancers may bleed intermittently, it is recommended that you take your sample from one bowel movement per day.

52. What if I develop diarrhea during the collection process?

If the diarrhea is such that you can't collect your sample, call for a new test at 204-788-8635 or 1-866-744-8961.

53. What if I suffer from constipation?

If you can not do the test within 7 days, this may not be the best screening test for you. Please talk to your doctor about screening.

54. What are the toilet bowl liners for?

The toilet bowl liner is used to help collect your stool sample. After urinating and flushing the toilet, unfold a toilet bowl liner and drop it in the toilet so that the edges of the tissue stick to the sides of the toilet bowl. Have a bowel movement. The stool will fall onto the toilet bowel liner. You will then use the applicator stick to collect the stool.

55. What if the toilet bowl liners tears and the stool sample falls into the toilet water?

If there are no chemicals in the toilet water and you are comfortable doing so, you can get the stool out of the toilet water using a clean container such as a margarine container. You can then use the applicator stick to collect the stool.

56. I have a septic tank. Is it ok to flush the toilet bowl liners, or will it plug up my system?

The collection tissues will dissolve and are designed to be flushed. However, if you have a septic tank, you may want to use an alternate method of stool collection such as using a clean disposable plastic container or paper plate.

57. What if I accidentally open the flap on the back of the collection card?

Close the flap and store the card away from heat, light, and chemicals.

58. I opened up the front flap on the sample collection card but am not ready to take the test. Is that OK?

It will be OK if you close the flap and store the card away from heat, light, and chemicals.

59. Why can't I store the collection card in a zip lock bag?

This may affect the results of the test. Store the card only in Envelope A until you are ready to return it.

60. Can I store the collection card in the fridge or freezer?

61. I don't have enough applicator sticks (e.g., lost one, threw one away, used two sticks to get one sample). What should I do?

You can use any clean hard object (such as a clean Popsicle stick or a plastic knife) to obtain your sample.

62. I tore the three sections of the collection card apart. Is that OK?

Yes, just ensure your name and collection dates are written on all three flaps.

63. What should I use to write my name and collection date on the collection card?

Use a permanent pen.

64. I lost my brown postage-paid envelope. Can I send the kit back in another envelope?

No, please call ColonCheck at 204-788-8635 or toll free at 1-866-744-8961 and we will send you a new envelope.

65. My doctor or nurse has told me I have hemorrhoids, should I complete the home screening test?

You may complete the test as long as your hemorrhoids are not bleeding.

66. I have noticed there is blood in my stool and I think it is from hemorrhoids, but I am not sure. Should I complete the home screening test?

No, do not complete the test if you have blood in your stool or notice any sign of bleeding after a bowel movement. Even if hemorrhoids are present, bleeding may be occurring as a result of another more serious problem and needs to be investigated. Contact your Doctor or Nurse Practitioner for an appointment.

67.Sometimes when I strain during a bowel movement, I notice blood in the stool. This doesn't happen all of the time. Should I complete the home screening test?

No, do not complete the test if you have blood in your stool or notice any sign of bleeding after a bowel movement. Even if hemorrhoids are present, bleeding may be occurring as a result of another more serious problem and needs to be investigated. Contact your doctor or nurse for an appointment.

Top

Your Test Result

685. How will I get my test result?

We will mail you your test result if it is normal. If it is abnormal, you will get a phone call from ColonCheck's Follow-up Coordinator and a letter in the mail.

69. Who else gets my test result?

Your doctor or nurse (if you specified one when you filled out the yellow Response Form) will be sent a copy of your results.

70. What does it mean if I have an abnormal result?

An abnormal result means that there was blood found in your stool. This doesn't necessarily mean that you have cancer. There may be many reasons for blood being found in your stool such as:
- You may have non-cancerous polyps, an inflamed colon, hemorrhoids, an anal fissure, or a stomach ulcer that is bleeding.
- You may have eaten something (for example red meat) or taken medications (for example Advil®) that caused the test result to be abnormal.
- The home screening test is not perfect: It may say there is blood when there really is none.
Follow-up testing is needed to determine the reason for your result. Often, a colonoscopy is recommended. A colonoscopy is a common procedure that allows a specialist to look at the inside of your colon and rectum to make a diagnosis.

71. If I completed the home screening test and the result was normal, is there any chance I could still have cancer or polyps?

Yes, because:
- Polyps don't always bleed, so irregular bleeding may be missed. The sample may have been taken on a day when the polyps weren't bleeding.
- The test sample may have deteriorated between collection and analysis.
- The home screening test may miss blood in a sample.

72. If colon cancer develops so slowly, why screen every two years?

Blood may have been missed in earlier tests.
Small changes may have occurred since the previous test.

Colonoscopy

73. What is a colonoscopy?

A colonoscopy is a common procedure that allows a specialist to look at the inside of your colon and rectum to make a diagnosis.
Click here to download a brochure on colonoscopy in English.
Click here to download a brochure in French.
Click here to watch a video explaining the colonoscopy.

Top

About Us

Patient & Family

Screening & Prevention

Health Care Professionals

Research

CancerCare Foundation

Colon Cancer and Polyps

Colon Cancer Screening

ColonCheck

Using the Home Screening Test

Your Test Result

Colonoscopy

Colon Cancer and Polyps

Colon Cancer Screening

ColonCheck

Using the Home Screening Test

Your Test Result

Colonoscopy

	Home Referrals Careers Volunteer Donations Departments Feedback Staff
		Contact Us

About Us Vision, Mission and Values Where are we located (maps) Code of Ethics Board Members Senior Management Corporate Publications Programs Incidence, Risk Factors and Future Cancer Rates Tomorrow Starts Today Patient & Family About Your Cancer Treatment Services Cancer Treatment Information - In Other Languages Support Services Volunteer Services Screening & Prevention Screening Information for the General Public Screening Information for Health Care Professionals Prevention Be PINK - Adolescent Breast Health Health Care Professionals Information for Health Care Professionals Clinical Hematology Education and Training School Of Radiation Therapy Research Clinical Trials Epidemiology & Cancer Registry Medical Physics Manitoba Institute of Cell Biology Manitoba Palliative Care Research Unit Research Resource Impact Committee CancerCare Foundation Reduce Your Risk