Why it’s time to start screening much sooner for colorectal cancer

For reasons that still aren’t certain, colorectal cancer is striking younger people like never before.

According to the Canadian Cancer Society, people aged 45 to 50 are now two to two-and-a-half times more likely to be diagnosed than in previous generations.

That is why experts are calling on provincial and territorial governments to lower the age of screening from 50 to 45 — and to provide people with stool tests every second year to look for early evidence of colorectal cancer.

Our guest on tonight’s episode of Village Media’s Closer Look podcast is Brandon Purcell, advocacy manager of prevention and early detection at the Canadian Cancer Society.

Transcript

SPEAKER_01 0:17

Welcome back to uh Closer Look Across the Village Media Network and available wherever you get your favorite uh podcast, uh including YouTube. I'm Scott Sexmith, Michael Friscolani. He is back.

SPEAKER_00 0:28

Uh can't leave for like three days. We missed you around here. Oh, my phone's just blowing up. Not for me. I did not bug you just a couple times. Well, maybe once or twice. That's all right. I it's okay. It's the way to do it. The news never ends. The news never sleeps. What's the old cliche? There's always something going on. Always.

SPEAKER_01 0:46

Uh as there was here. Uh Zach Tronzo, uh in for uh Derek Turner uh tonight. Derek back later uh this week. Uh no, actually he's off. I don't know who approved that, but he's not back till next week. Who, Derek? Yeah.

SPEAKER_00 0:59

Yeah, he's I think he's well we shouldn't say where he is. It's top secrets, classified undisclosed locations. Classified information. Yes, personal, personal, personal data. On assignment, right? Jerry's working hard. Yeah, I'm sure he is. He's working hard and targeted. Someone needs to let me know these vacation requests before they get approved. I know.

SPEAKER_01 1:15

I don't know who's approving this stuff, but it's not running uh being run by us. Uh okay. Let's uh talk about the uh Canadian Cancer Society. Uh right now they're trying to uh advocate to have the uh screening age for colorectal cancer screening reduced from fifty to forty five.

SPEAKER_00 1:31

Yeah, it's it's a story that's been in the news uh lately. We've seen in various uh across Canada and various parts of the United States and other jurisdictions, colorectal cancer rates have really gone up among younger people at a pretty alarming rate, right? And they don't necessarily know exactly why. They have their suspicions, it's lifestyle issues, but they're seeing a lot more younger people under the age of forty-five being diagnosed and being diagnosed in later stages of the disease. Yeah. So last week the Canadian Cancer Society announced that they want to lower the age at which screening starts to happen from 50 to 45, and they support the idea of sending the the kits that they're used, the at-home kits you can use to test for this kind of screen for it, offering all Canadians these their stool tests every two years from 45 to uh until 74, I guess, is the to kind of look for early evidence of colorectal cancer. Um so they've been promoting this, they're calling on governments across the country to do this. And it is it is it's sad because we have heard of cases, people know people who colorectal cancel is not something colorectal cancer cancer is not something you think of when you're in the 30s or 40s. No. But we're seeing more and more of these uh these cases. So they're on top of this. The kidney cancer society wants to lower the age of screening across the country. They've they've uh gotten a lot of headlines over this. So who are we gonna we're gonna talk to someone from the kidney cancer?

SPEAKER_01 2:47

Yeah, we are. Brandon Purcell's uh gonna join us. Uh Brandon is the advocacy manager of prevention and early detection at the Canadian Cancer Society. For years, colorectal cancer has been thought of as a disease that shows up later in life, something you start worrying about at age 50, but that assumption is starting to look dangerously outdated. New data shows younger adults are being diagnosed at sharply higher rates often later when the cancer is harder to treat. Now the Canadian Cancer Society is calling for a major shift, lowering the routine screening age to 45. They say it could prevent more than 15,000 cases and save over 6,000 lives in the coming decades. Brandon Purcell is the advocacy manager for prevention and early detection at the Canadian Cancer Society, and he's pushing for that change. And Brandon joins us tonight from Ottawa. Brandon, welcome to the program. We appreciate your time. Uh, Brandon, we've uh long associated colorectal cancer with people over 50. So, what's driving this shift towards uh younger diagnosis and how confident are researchers in that trend?

SPEAKER_02 3:56

Yeah, that's exactly right. We're seeing a lot more younger folks that are getting diagnosed with colorectal cancer. Uh, we're actually at the point where folks who are in that 45 to 50-year-old age range uh they're two to two and a half times more likely to be diagnosed with colorectal cancer than uh folks in previous generations, which is a pretty striking stat. Uh last year, there were 2,000 Canadians alone in that age bracket that were diagnosed with colorectal cancer. Uh, and that's without having access to a screening program. Uh so we know that unfortunately there are more folks out there who have colorectal cancer and they just don't know it. In terms of uh a cause, unfortunately, we don't really have one sort of smoking bull or smoking gun, uh, so to speak. We know certainly that uh things like genetics plays a factor. So if a relative has had colorectal cancer, uh you're certainly at f at increased risk. But other things like uh just your individual habits day to day can play an impact. Uh about 45% of all uh colorectal cancer cases can be prevented just by uh maintaining a good diet, uh refraining from smoking, keeping alcohol intake down, and having good uh good exercise because those good um habits compound over your lifetime to improve your your your chances just the same way that bad habits do.

SPEAKER_00 5:16

You touched on it, Brandon. Thank you for that. But the the the question of why is the big one. People are reading the headlines the last couple of weeks. Any more insight you can offer on the why?

SPEAKER_02 5:25

Like I said, there's a there's a there's a number of reasons, unfortunately. Certainly um some things we talk about are um high pro highly processed uh foods play some role. We're at we at the Canadian Cancer Society are looking to narrow zero in sort of on how much of a role that actually is. So we we we've um put some put some money towards some research on that issue in particular. We know smoking is uh is a contributor to colorectal cancer. We know that alcohol is alongside uh eight other cancers.

SPEAKER_00 5:56

That's a great point. I guess this is a dumb question, Brandon. But at the Canadian Cancer Society, a lot of the things you're warning against are similar for a lot of cancers, right? A lot of it is lifestyle driven. Can you speak to that in terms of how much is lifestyle driven and how much is maybe environment or other genetic things?

SPEAKER_02 6:11

Yeah, certainly. Uh about uh the the math is quite close to about half of all cancer cases um can be prevented through uh through sort through just maintaining healthy lifestyle habits. Um it's uh it's quite it's quite a dramatic number uh that we can get down just by uh doing the doing some of those simple things like main like uh having having a good workout regimen, having uh good uh a good diet and refraining from smoking. I don't want to repeat my repeat myself too much, but it really can just be that simple. It's important to get those cases down.

SPEAKER_01 6:44

Brandon, the modeling suggests thousands of cases uh and deaths could be prevented by making uh this change that we're talking about today. What assumptions are those projections based on? And how strong is the consensus behind them? And is this one of those rare moments where where the data is maybe ahead of the policy?

SPEAKER_02 7:02

It's a great, it's a great question. Uh, and really the change, what the effect that the change will have uh is providing that early detection. Because when a cancer, uh including colorectal cancer or any, is found early, it makes all the difference in the world to the person who uh who is receiving that diagnosis because when it's found early in those earlier stages, uh it is so much easier to treat. It is the likelihood of survival is so much higher. So, just as an example on colorectal cancer, when it's found early, stage one or so, or if they're even better in that pre-cancer stage where they're looking for polyps, uh, your chances of survival past five years are over 90%. Uh, but when it's found in the later stages, uh stage four, that number decreases dramatically down to about 15%. Uh and that's why, despite the fact that colorectal cancer um is uh is not one of our highest uh uh highest diagnosed, it is definitely the second deadliest after long.

SPEAKER_00 7:59

Are there symptoms that show up, Brandon, before people even get screened? Are there things that you can be looking for?

SPEAKER_02 8:04

There are certain symptoms. I'll just say off the top, I'm not a not a physician, so I can't offer medical advice. But uh some of those things that uh are are certainly uh symptoms are a lot of prolonged um intestinal pain, um blood on the stool, bleeding from the rectum are those sorts of things that uh could indicate you you you should definitely be chatting with your with your physician. Um but uh we we really want people to be able to proactively go for that screening. So what we're talking about today um is for folks to have access in that younger age demographic to something called a fit test, which uh stands for fecal immunochemical test. It's a complex term that I trip over myself with for something that's actually quite simple. Um and what it is is uh a uh a kit that's can that can be mailed to you. So it's something it's a test you can actually do in the comfort of your own home. You don't have to go to your doctor to do it, you don't have to go to a lab to do it. You can have a kit mailed to you, and what you'll find in there is a uh sort of test tube and uh a stick. What you're gonna do is take this, take uh the stick, just grab a sample uh after you take a poop, put that back in, put it in the bag, and send it to the lab. It may not be uh it may be a little uh gross, uh, but it's a simple thing that you can do to stay on top of uh on top of your cancer risk.

SPEAKER_01 9:16

Brandon, for people who hear screening and think colonoscopy, it's it's not that so and I know you just touched on it a little bit, but so what it what does it look like? How accessible is it? And and maybe describe that screening process uh for us. Absolutely.

SPEAKER_02 9:29

Uh so colonoscopy is certainly uh something that happens along the diagnostic pathway, but thankfully it's not the first step. So it's what happens when there are signs that are more worrying. So that that fit test is something that uh you're you're able to do in the comfort of your own home. It's a uh a stick that comes in a test tube that you use to take a small poop sample, pop it in in the in the vial, and send it uh send it in the in the mail back to a lab. If there's something that looks concerning, then the the uh then your physician or the cancer program will get in touch with you and say, hey, we've picked up something on on your test. It's we're gonna perhaps have you in for a colonoscopy. So that's the second step.

SPEAKER_00 10:08

I appreciate that. Obviously, this is what's concerned to people is just the fact, like we talked about that it's it's younger people that are getting diagnosed with this or getting impacted with it. Are there personal stories you can share? I mean, there's obviously that shock value, that shock level that happens too when it's someone younger not expecting to get this kind of cancer at that young age. Any personal stories you can share with us, Brandon?

SPEAKER_02 10:27

I mean, certainly uh we we we are getting more of these cases every single year. Uh the real impetus behind this is that we've been seeing this trend. It's not just something that we see in Canada. Um, other countries have seen this trend where younger folks are being diagnosed with uh with the with these cancers um at an early at an earlier age. Uh and missing out on having that opportunity to screen means that for those folks who uh might be getting it, getting this early onset cancer, that when it is eventually found um later in life, that it's gonna, it's almost certainly going to be at one of those more advanced stages where it's gonna be harder to treat and uh the likelihood of survival is gonna be lower. Um, that's why it's so important that uh Ontario is able to bring this age down to 45 just to give those folks access to that screening.

SPEAKER_01 11:18

Brandon, if someone's watching or listening uh to closer look tonight, that is 45 or 50 uh years of age and assumes, you know what, I'm I'm far too young to worry about this. What do you say to those people?

SPEAKER_02 11:31

What I say is uh it's important for we have for all of us to stay on top of our health. Uh we uh we we each have one precious life and we want to be doing everything we can to take care of ourselves. And it's some sim sometimes very simple things that we can do to uh to take to take care of ourselves to make sure we're living happy and long lives. Um it's uh eating eating fruits and veggies, and uh on occasion, once every two years, it's gonna be taking uh taking a poop sample and putting it in the envelope.

SPEAKER_00 11:59

Appreciate all this, Brandon. What else is on the Radio Kidney Cancer Society right now that's kind of on the top of the page?

SPEAKER_02 12:06

Well, there's certainly never any shortage of uh of things that we're we're talking about. Um one that one thing that we're certainly focused on right now is uh bringing in new way, new and innovative ways for folks to have access to um to uh innovative therapies. So uh we're very cognizant of the fact that there's a shortage of basically everything when it comes to our our health system, unfortunately. So we want to find those workarounds and new ways where it's possible to uh uh to bring new and innovative treatments. So we're talking a lot about uh improving access to clinical trials so that when folks are having that first conversation with the doctor, the very difficult conversation after hearing uh those those horrible words, you have cancer, that there are more options available to them than uh than talking about talking about radiation and talking about uh those uh those other therapies.

SPEAKER_01 13:01

Uh anything else to add, uh Brandon, before we we uh let you go tonight?

SPEAKER_02 13:05

I just I appreciate you uh you taking the time to cover this uh this subject. It's an important one. Uh if folks uh who are who are listening are interested in helping us out, uh certainly would encourage encourage you to write out right to your MPP um and uh tell them that uh this is gonna be a life-saving measure. Uh it's gonna uh make uh make a real difference for folks across the province. Um and from the crass political sense, it's gonna save the government money.

SPEAKER_01 13:29

All right, there's Brandon Purcell, the advocacy manager of prevention and early detection at the Canadian Cancer Society. Uh Brandon, appreciate your time tonight. Thank you. So much better to uh have the testing option to do it at home. You know, it's a little more comfortable. And uh what surprised me that uh Brandon said was uh colorectal cancer next to lung cancer, the number two in the cancer.

SPEAKER_00 13:53

I I would say it kind of threw me off when I heard you. I didn't I never thought of that. You know, cancer is a terrible friggin' thing, Scott. I've talked on the show openly and honestly, I've been dealing with cancer for almost a decade now. Had kidney cancer, took my kidney out, metastasized, had all kinds of crazy surgery done to cut me up like a fish. Um and I'm always in awe of these people that work in cancer uh research or cancer advocacy because this stuff makes a difference. These people are if if people get screened earlier, they're gonna catch it earlier, they're gonna save lives. So I hope if we have a small part in relaying that message to people that there's there's ways to stay on top of this stuff, then do it because he's right. You get one life, brother. You get one chance. So you take advantage of it and uh you enjoy it. I'm grateful to be here. Not so much sitting here with you, but here in general. I get what you're paying for. And I'm just kidding.

SPEAKER_01 14:42

Aaron Ross Powell, Jr. Let me ask you this. Do you feel and and you can obviously speak to this you know more intimately than most. Do you feel like we're closer to finding a cure?

SPEAKER_00 14:51

Aaron Ross Powell I don't know if finding a cure, but I can tell you if it's a personal journey, any anyone who's dealt with cancer in a significant way and has gone through that journey isn't I think what blew me away. And I think the journalist in me was blown away, because I'm kind of learning as I go, right? Yeah. Just how far they've come. Like the thing, I I should be dead. I mean, I should be. I should be dead. And I was told that. And uh that what they were able to do for me to take out this metastasized chunk of cancer was just it's phenomenal. It's almost it's out of this world what they were able to do. And so cure, who knows? But I think it the amount of people that they've kept alive and the advancements they've made. And I always think back to that conversation we had with Terry Fox's brother. I was just thinking about that. It was just such a powerful conversation about how that, you know, so many people have done amazing research and helped with the advancements that we have. And then you have a guy like Terry who did that run that is still it makes me emotional thinking, you know, how much. What did Darrell say a little bit? Cancer research. So and then you have the Canadian Cancer Society doing the kind of advocacy work they do and getting that message out and staying on top of it. Um just think of the fight they took on over smoking for decades. Right. Canadian Cancer Society was leading that fight, right? Certainly were about about getting warning labels, getting the basically single not single-handed, but they basically helped lead the charge to basically wipe out the cigarette industry, right? You don't even know they're for sale anymore. They're stuck behind a counter somewhere. So I just think there's so many people doing amazing things. I'm not a doctor at all. Do I think there could be a cure? Who knows? But in terms of treatments, you think of Terry Fox, you know, the cancer he had, he'd be alive today. They would they would have treated it and found ways to keep him going. And it didn't for him, and that was how many years ago? Almost five decades ago. That's crazy. Right? So we've come a long way. This is always uh uh this topic hits home. Um so if you can get if you are in your forties and you I think it's worth your time to ask for this toolkit, do it. Take the test, you get one chance, one shot at it, and then enjoy it what and uh and and try to uh you know be as healthy as you can. I think that's the message. All right. Appreciate you sharing that. We're glad you're here. Right on, baby.

SPEAKER_01 17:00

Most days. Closerlook at villagemedia.ca. Reach out anytime. We would love to hear from you, and uh by all means sign up to receive uh our show right into your inbox every night. Closerlookpodcast.ca. For Michael Friscolani, our editor-in-chief here at Village Media. I'm Scott Sexmith. Thanks for watching. We'll see you tomorrow night at seven right here on Closer Look. Fresco and Scott's wardrobe, provided in part by Moore's through St. Marie.