Quebec’s health ministry is maintaining its recommendation that colorectal cancer screening begin at age 50, rather than lowering it to 45, despite calls from numerous experts and organizations across the country, CTV News can reveal. The Canadian Cancer Society urged provinces and territories in March to lower the screening age for colorectal cancer from 50 to 45, following increasing evidence that the disease is rising in younger adults. Prince Edward Island and Ontario are the first two provinces to do so. In Quebec, colorectal cancer screening is currently recommended for individuals with no symptoms aged 50 to 74 who are at average risk of developing the disease. “This stance is based on the evidence, which does not currently suggest that population-based colorectal cancer screening through a structured, organized program involving invitations should be offered to those under the age of 50,” the health ministry said in a statement to CTV News. The ministry says its position is based on data from the Quebec Cancer Registry, which monitors trends in cancer incidence and mortality across various cancer types. It also relies on scientific assessments and recommendations from the province’s Institut national d’excellence en santé et services sociaux (INESSS), which is commissioned by the ministry to conduct the assessments. The recommendations are finalized by INESSS and Quebec’s health minister. It may also draw on committees of experts that monitor and recommend best practices for cancer screening and treatment, the statement said. Colorectal cancer rising in young adults Colorectal cancer is the fourth most commonly diagnosed cancer in Canada in 2026, and it is the second deadliest cancer, according to the Canadian Medical Association Journal. The fecal immunochemical test (FIT), a stool test that checks for blood, is used to screen for this type of cancer. An estimated 25,300 people will be diagnosed with colorectal cancer in Canada in 2026, and 9,200 people will die from it. In Quebec, 7,300 people are expected to be diagnosed with colorectal cancer in 2026, and 2,300 are expected to die from it. Among Canadians aged 30 to 49, colorectal cancer accounts for 7 per cent of all cancer cases. Barry D. Stein, CEO of Colorectal Cancer Canada, has been working closely with Quebec’s health ministry on lowering its recommended screening age. “The evidence concerning adults aged 45 to 49 has evolved substantially. Quebec data show that colorectal cancer incidence in this age group is no longer negligible and that younger birth cohorts are experiencing considerably higher rates than earlier generations,” Stein told CTV News. “International evidence now demonstrates that FIT screening before age 50 can reduce colorectal cancer incidence and mortality, while studies of screening among adults aged 45 to 49 show meaningful clinical yield.” A recent Canadian study published in March demonstrated that screening at age 45 would result in over 15,000 fewer colorectal cancer cases and 6,100 fewer deaths over the next 45 years in Canada. “We have to address this early-onset that is happening all through North America. I find it extremely hard to believe that Quebec would be an enclave within the whole of North America where this isn’t happening,” Stein said. “If Quebec believes further evidence is required, it should define precisely what evidence would change its position and when the question will be reconsidered.” Colorectal cancer screening in Quebec Quebec is the only province or territory in Canada without an organized screening program for colorectal cancer that invites people to get screened. Instead, it relies on what’s known as opportunistic screening, in which individuals book their own appointment through Clic-Santé to be screened at a local service point once they turn 50. People younger than 50 and at higher risk of developing the disease can also consult a doctor to request earlier screening. In addition to lowering the screening age, Colorectal Cancer Canada has also been advocating that Quebec establish an organized screening program similar to what it does with breast cancer screening. “A program with centralized invitations, reminders, recalls, co-ordinated follow-up and transparent performance reporting would reach many people who are currently missed by an opportunistic system, particularly those without regular access to primary care,” Stein said. The ministry told CTV News in the statement that it is establishing the necessary prerequisites for the roll-out of an organized screening program. However, Stein says it has been several years and multiple governments since his organization began calling for the completion of the organized program. “Quebec continues to rely largely on opportunistic screening delivered through primary care. This distinction matters. In an opportunistic system, individuals generally receive screening only when a health-care provider identifies them as eligible and initiates testing,” Stein said. “In an organized program, the health system proactively identifies eligible people, invites them to participate, reminds them when screening is due, co-ordinates follow-up after abnormal results, and monitors quality and outcomes across the entire pathway.” Advocates want action Quebec’s Cancer Coalition is also advocating that the province expand colorectal cancer screening and establish an organized screening program. Executive Director Eva Villalba says the current screening model in Quebec is not serving Quebecers. She said participation in colorectal cancer screening is 38 per cent, while the national objective is 60 per cent. She also said the province’s labs are already struggling to process tests and deliver results promptly due to a shortage of technicians, citing patients who have waited weeks for their results. “Quebec’s health ministry is not lowering the screening age because we already can’t serve the current people that are eligible,” Villalba said. “They are not admitting that it’s a capacity issue because then they would be obliged to do something about it.” “Cancer doesn’t wait for these bureaucratic delays.” Quebec’s National Assembly unanimously adopted a motion nearly three years ago calling for the implementation of the Quebec Colorectal Cancer Screening Program before the end of the Coalition Avenir Québec (CAQ) government’s mandate. Stein says that ahead of the election in October, their organization is calling on all parties to complete implementation of the organized screening program and lower the recommended screening age. “Every year of delay means missed opportunities to prevent cancer or diagnose it at a more treatable stage. Quebecers deserve a modern, equitable and accountable colorectal cancer screening program,” Stein said. “The evidence is available. The infrastructure is largely in place. The commitment has already been made. Now Quebec must deliver.”
