A new era of screening with the fecal immunochemical test (FIT): Preparing for recommendation changes and ColonCancerCheck enhancements

On July 1, 2026, Ontario Health (Cancer Care Ontario) will be implementing several changes to the ColonCancerCheck (CCC) program, including lowering the screening start age from age 50 to 45 for people at average risk and updating screening recommendations for people with an increased risk of colorectal cancer due to family history. In addition, CCC is transitioning to a new laboratory service provider for the distribution and testing of new fecal immunochemical test (FIT) devices.

Nurse practitioners play a critical role in supporting colorectal cancer screening in Ontario. This presentation aims to provide an overview of the key changes to program pathway along with several programmatic enhancements to primary care providers (e.g., direct mailing of result letter/FIT kit to people with unsatisfactory results, improved lab result reports, and a FIT kit reminder letter). The presentation will also review the supporting evidence behind the changes and resources to support primary care.
Learning Objectives; 1. Review emerging evidence of colorectal cancer and how it has shaped Ontario Health (CCO) colorectal cancer screening recommendations in Ontario.

2. Prepare for changes to the ColonCancerCheck program on July 1, 2026, highlighting the unique role that nurse practitioners play in patient screening and navigation.