News

Catching a silent killer

A letter from the Winnipeg Health Region

BY ARLENE WILGOSH
Winnipeg Health Region President & CEO
Wave, May / June 2013

Arlene Wilgosh
Arlene Wilgosh

What do you get when you put 15 people in an office with some popsicle sticks, a postage machine and a list of addresses?

Well, in the case of the people working at ColonCheck, you get an innovative program that has been extremely effective in catching the silent killer that is colon cancer. Let me explain.

Several years ago, Dr. Dhali Dhaliwal, President & CEO of CancerCare Manitoba, approached the provincial government with a proposal to establish a program that would essentially seek to screen all Manitobans between the ages of 50 and 74 for colon cancer.

As the deputy minister of health at the time, I can tell you that the government was very keen on the idea for obvious reasons. As this story points out, colon cancer can be deadly, killing an estimated 330 people in this province last year alone.

But it is also very treatable, especially if it is caught in the early stages. So the idea of creating a screening program to catch the disease before it could do its damage made a lot of sense. The big question was how should it be done?

Historically, the decision of whether to get screened has rested with the individual and his or her family doctor. But what about those who don't have a family physician or don't visit their doctor as often as they should?

Dhaliwal's plan got around these obstacles. Under his proposal, CancerCare Manitoba would distribute home screening tests - consisting of three small sticks, a few paper folders and an envelope addressed to the lab - by mailing them out to all eligible Manitobans.

As our story explains, individuals receiving a test can screen themselves in the privacy of their own homes simply by collecting stool samples and mailing them to a lab for analysis.

Given that the province had already launched major screening initiatives for breast and cervical cancers, creating a program to screen for colon cancer was the next logical step.

Once approved, the program, one of the first in Canada, was rolled out in stages, starting in 2007. Now, six years later, the ColonCheck team is achieving some noteworthy milestones.

Since its inception, it has mailed out more than 260,000 home screening tests, including 94,790 in 2012/13 alone. It is estimated that about 70,000 Manitobans have completed a home test since 2007. As a result, between Jan. 1, 2009 and Dec. 31, 2011, more than 850 followup colonoscopies have been ordered and 36 cases of colon cancer have been diagnosed.

These are significant achievements, ones that the ColonCheck team can be proud of. But, of course, the people at ColonCheck are not resting on their laurels. They continue working to boost the response rate among eligible Manitobans. Two years ago, the annual response rate to the mail-out screening tests in a single year was about 23 per cent. Last year that rate jumped to 30 per cent, in part because of changes that have made it easier to complete the test.

The increase in the response rate is good news. But there are still a significant number of Manitobans who aren't taking advantage of the opportunity presented by these mail-out tests.

As Dr. Kathleen Clouston, Interim Program Manager of ColonCheck, notes in our story, part of the reason for this gap may be that many people don't realize how insidious colon cancer can be.

Len Clace's tale illustrates the point. As our story reports, the retired RCMP officer almost threw out the home screening test he received in the mail in 2008. He reasoned that he was feeling perfectly fine and showed no symptoms of being ill, so there was no need for him to do the colon cancer screening test.

Fortunately, he changed his mind. When his samples were analyzed, it was determined that he did have microscopic amounts of blood in his stool and a colonoscopy was ordered. Eventually, he was diagnosed with colon cancer and had surgery to remove his colon.

Clace has been cancer-free since his operation and is now telling his story in Wave in the hopes of convincing others to get screened. As he says in the story, "I think fear of the unknown keeps a lot of people from taking the test. I've talked to people who don't want to know, but they're eventually going to know and it's going to be too late. I just wish people would get checked and get checked early."

Clace says ColonCheck saved his life. We can't know precisely how many other lives have been saved by the program because it is conceivable that some of those screened might have been screened even without the program.

But there is no question in my mind that ColonCheck has made screening easier, simpler and more accessible to tens of thousands of Manitobans who might not otherwise get screened, and that many lives have been - and will continue to be - saved as a result.

Not bad for 15 people in an office with some popsicle sticks, a postage machine and a list of addresses.

Wave: May / June 2013

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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