Ontario has expanded its routine colorectal cancer screening program to include people aged 45 to 49, lowering the previous eligibility threshold of 50. The change means Ontarians aged 45 and older can receive a fecal immunochemical test, known as FIT, for use at home.
FIT looks for traces of blood in stool that may indicate a need for further investigation. A person who receives an abnormal result can be referred for a colonoscopy. Ontario is the second Canadian province to begin routine screening at 45, following Prince Edward Island, which introduced the lower starting age in March 2026. Other provinces continued to recommend FIT screening for average-risk adults from ages 50 to 74 at the time of Ontario's change.
The expansion applies to people considered at average risk of colorectal cancer. Screening pathways differ for those with a stronger family history. A person may be considered at higher risk when a parent, sibling or child was diagnosed before age 60, or when two family members were diagnosed at any age. Higher-risk patients generally receive colonoscopies instead of FIT and may begin at age 40 or 10 years before the age at which their relative was diagnosed, whichever comes first.
FIT is intended for screening people without symptoms, rather than diagnosing those who are already showing possible signs of disease. People experiencing blood in the stool, rectal bleeding, changes in bowel habits or anemia should seek assessment from a health-care provider, who can determine whether a colonoscopy or another diagnostic procedure is appropriate.
Advocates have linked the policy shift to concern about colorectal cancer among younger adults. Barry Stein, president of Colorectal Cancer Canada, said provinces were at different stages of reviewing whether to lower their screening ages. He and the Canadian Cancer Society urged other jurisdictions to follow Ontario and Prince Edward Island.
Early detection can substantially improve outcomes. Cancer Care Ontario says nine in 10 people can be cured when colorectal cancer is found early. Polyps in the colon or rectum can also be removed before they become cancerous.
The Canadian Cancer Society cautioned that no screening method is completely accurate, but said evidence supports regular FIT or stool testing, together with appropriate follow-up, as a way to reduce the risk of death from colorectal cancer. That limitation was illustrated by Ottawa survivor Trish Riley, who had a false-negative FIT result months before unexplained blood loss led to a colonoscopy and a stage 3 diagnosis at age 51. Riley underwent surgery and chemotherapy, and later scans showed no cancer. She welcomed the lower eligibility age while emphasizing the value of finding the disease sooner.
