By the time Steve Slack was diagnosed with colorectal cancer, doctors told him it was incurable.
The Bowmanville, Ont., resident started experiencing symptoms around age 45, but says his doctor thought they might be food sensitivities.
“I was misdiagnosed,” he told CBC News.
Slack wasn’t diagnosed until 2021, when he was 48. He says he waited around three months for a colonoscopy and at that point, he learned he had Stage 4 colon cancer.
“The surgeon said ‘I couldn’t even do the colonoscopy, because the tumour was so big,'” Slack recalled.
Because of his experience, Slack recognizes Ontario’s decision to lower the age for screen is a step in the right direction, but he also worries about the province’s capacity.
Starting next month, Ontarians who are 45 years old will be eligible for colon cancer screening. The province is lowering the age from 50, due to a notable increase in young people with the disease.
People who are at a higher risk will be able to screen even earlier, at age 40. The province says the expansion is expected to give more than one million additional people the option to connect to screening services to detect and treat colorectal cancer sooner. But some patients and advocates question whether the province is ready for the additional pressure on the system.
“I’ve of course been for several colonoscopies since my cancer diagnosis, and there are definitely capacity issues,” Slack said.
Ontario Health says it’s ready to scale up capacity
In a statement, Ontario Health said Cancer Care Ontario monitors wait times from an abnormal fecal immunochemical test (FIT) result to a colonoscopy as a key measure of access to care.
“Most people with an abnormal FIT result receive a follow-up colonoscopy within the recommended 8-week timeframe, demonstrating Ontario’s readiness for the ColonCancerCheck changes,” the statement said.
Ontario Health also said it has been working to improve access and patient flow.
“Ontario has also invested in 57 community surgical and diagnostic centres that are helping connect over 1.2 million people to MRI scans, CT scans and gastrointestinal endoscopy services, with nearly 20,000 additional gastrointestinal endoscopy procedures completed since the program launched in June of 2025,” it said.
‘We’re building out the capacity,’ says gastroenterologist
Dr. Akshay Shetty, a gastroenterologist and director of endoscopy at Toronto’s Michael Garron Hospital, says as the health-care system works to accommodate a rising number of patients, where they receive the care might be slightly different.
“We’re building out the capacity to meet those needs,” he explains.
“So for example, at Michael Garron Hospital we have an advanced endoscopy centre where we remove these large lesions or these cancers. But if you’re a healthier person and what we deem as a lower risk colonoscopy, we’re actually trying to move some of those scopes from the hospital setting into an out of hospital endoscopy centre.”
Barry Stein, president and CEO of Colorectal Cancer Canada, said the group is estimating around 50,000 or so additional colonoscopies could result from the average of positive FITs that come from the expansion.
But he remains optimistic about potential capacity challenges.
“We faced this during COVID which wasn’t such a such a long time ago, and they were able to catch up with the additional capacity as more people asked for the test.”
In addition to prevention, his group is also pushing to ensure that people have access to biomarker testing, clinical trials and faster access to treatment overall.
Barriers to effective screening remain: gastroenterologist
Meanwhile Dr. Daniel Green, president of the Ontario Association of Gastroenterology, says while the association supports the recent expansion of screening eligibility, barriers to effective screening remain, including timely access to colonoscopies.
“Further action is required to ensure all eligible patients receive the health care they require,” Green said in a statement.
The association has recommendations for the province, which include expanding health service centre funding even further, applying a patient-centred approach where the patient participates in selecting their screening method and providing incentives for gastroenterologists to serve under-serviced areas in Ontario.
Colon cancer is the second leading cause of cancer death in Canada and is affecting younger people at higher rates. CBC’s Stephen Quinn spoke with The Early Edition’s medical columnist Dr. Peter Lin about what people need to watch out for and what could be the cause of increasing rates for people under 50.
Slack, who is now 53, says looking back, he wishes he was more persistent with doctors when he felt something was off.
He’d like to see the screening age lowered even further, and hopes to see more public awareness encouraging people to participate in the screening programs.
“I’ve been extremely lucky and I haven’t had treatment in two and a half years. So my story was a rare success. I feel like it’s a miracle.”
