At a glance
- Since July 1, 2026, Ontario offers screening from age 45 for people at average risk. It used to start at 50.
- At average risk, do the FIT stool test every 2 years from age 45 to 74.
- To get a FIT kit, ask your family doctor or nurse practitioner. No family doctor? Call 811 (TTY 711) or visit Health811 online.
- If your FIT is abnormal, you need a colonoscopy, ideally within 8 weeks. Don't repeat the FIT.
- If a parent, brother, sister or child had colon cancer before age 60, or two or more had it at any age, you need a colonoscopy every 5 years. Start at 40, or 10 years before the youngest relative was diagnosed, whichever comes first.
- If you have Crohn's or colitis, polyps that need follow-up, or a gene condition such as Lynch syndrome, follow your specialist's plan instead.
- Blood in your stool, a lasting change in bowel habits, weight loss or low iron? See your doctor now, at any age. Don't wait for screening.
Why get screened?
Colon cancer often starts as a small growth called a polyp. It can take years to turn into cancer, and you may feel fine the whole time. Screening looks for signs of cancer or polyps before you have symptoms. When colon cancer is caught early, 9 out of 10 people can be cured.
The main screening test in Ontario is the FIT (fecal immunochemical test). It is a simple stool (poop) test you do at home. It checks for tiny amounts of blood that you can’t see.
What changed in July 2026?
On July 1, 2026, Ontario’s ColonCancerCheck program lowered the age to start screening:
- Average risk: from age 50 to age 45
- Higher risk because of family history: colonoscopy from age 40 (or earlier, see below)
Ontario is mailing invitation letters to people aged 45 to 49 over two years. You don’t need to wait for your letter. Your family doctor or nurse practitioner can order a FIT for you now.
Which screening is right for me?
Answer a few questions to see what Ontario suggests for you. Nothing you enter is saved or sent anywhere.
Your answers
For adults in Ontario with OHIP. Answer each question.
Grandparents, aunts, uncles and cousins don't count here. Neither do relatives who only had polyps.
Answer 4 more items to see the result.
- Symptoms
- Your own health history
- Family history
- Your age
Here are the same rules in a table. “Relative” means a parent, brother, sister or child.
| Your situation | Test | How often |
|---|---|---|
| Age 45 to 74, and no relative with colon cancer, or only one relative diagnosed at age 60 or older | FIT stool test | Every 2 years |
| One relative diagnosed before age 60, or two or more relatives at any age | Colonoscopy | Every 5 years, starting at age 40 or 10 years before the youngest relative was diagnosed, whichever comes first |
| Age 75 or older | Talk to your doctor | Routine screening isn’t advised after 74. From 75 to 85, it depends on your health. After 85, screening is not advised. |
Some family history does not raise your risk group. This includes relatives who had only polyps, and grandparents, aunts, uncles, cousins, nieces or nephews with colon cancer or polyps.
You need an Ontario health card (OHIP) to use the program. If you are at average risk and had a normal colonoscopy, you may not need another test for 10 years. At higher risk, the next colonoscopy is due in 5 years. Ask your doctor.
How do I get a FIT kit?
A family doctor or nurse practitioner orders the kit for you. You can:
- Ask your family doctor or nurse practitioner
- Call 811 (TTY 711) or visit Health811 online, if you don’t have a family doctor or nurse practitioner
- Visit a mobile screening coach, in some areas
- Contact your health centre or nursing station, if you live in a First Nation community
The kit comes by mail
It comes to your home. Follow the steps in the kit. The kit has steps in English and French. You can also find them online in more than 35 other languages at ontariohealth.ca/fitinstructions.Send it back
Send it back as soon as you can, ideally within 2 days of taking the sample. Use the prepaid envelope, or drop it off at any Rexall pharmacy.Get your result
You will get a letter with your result.
What if my FIT result is abnormal?
An abnormal result means blood was found in your stool. It does not mean you have cancer. Blood can also come from other things, such as hemorrhoids or your period. But you do need more testing.
- The next step is a colonoscopy, a test that uses a thin camera to look inside your colon. It can also remove polyps.
- Ontario advises having it within 8 weeks of your result. Your doctor will refer you.
- Don’t repeat the FIT. Doing it again can delay finding and treating a problem.
- No family doctor? Call Ontario Health at 1-866-662-9233 to talk about next steps.
If your colonoscopy is normal, you can usually wait 10 years before your next screening test. Read our colonoscopy preparation guide to learn how to get ready.
Who needs a different plan?
The usual screening rules are not for everyone. Talk to your doctor or specialist if you have:
- Crohn’s disease in the colon, or ulcerative colitis. People with IBD need check-up colonoscopies on their own schedule. Your IBD team will plan these with you. Read our IBD monitoring guide.
- Polyps removed in the past that need follow-up colonoscopy
- Had colon cancer before
- A gene condition that runs in families, such as Lynch syndrome or familial adenomatous polyposis (FAP). If one is suspected in your family, ask about a referral to a genetics clinic.
Symptoms that need a doctor, at any age
Screening is for people who feel well. Don’t wait for a screening test if you have any of these. See your family doctor or nurse practitioner, or a walk-in clinic:
- Blood in your stool, bright red or very dark
- New diarrhea or constipation that doesn’t go away, or feeling that your bowel doesn’t empty all the way
- New stomach discomfort that doesn’t go away
- Losing weight without knowing why
- Low iron (anemia) on a blood test
- Stools that are narrower than usual
These need a proper check, often with a colonoscopy. A FIT is not the right test when you have symptoms.
Sources for this guide
Sources
- Government of Ontario. Colon cancer testing and prevention. ontario.ca, updated 2 July 2026. From 1 July 2026: age 45 for average risk, 40 for increased risk. Average and increased-risk definitions; FIT every 2 years; colonoscopy every 5 years from 40 or 10 years before the youngest relative's diagnosis; how to get a kit (provider, Health811 at 811/TTY 711, mobile coach, First Nations health centre); return within 2 days; colonoscopy within 8 weeks of abnormal FIT; symptoms list; IBD and polyps may need colonoscopy instead.
- Ontario Health. Colon cancer screening eligibility is changing in Ontario. Updated 2 July 2026. Invitations to people aged 45–49 roll out over two years; your doctor or nurse practitioner can order a FIT before your letter comes; no doctor: call 811 (TTY 711).
- Ontario Ministry of Health. Ontario lowering eligibility age for life-saving colon cancer screening. News release, 7 May 2026. Eligibility lowered from 50 to 45 for all, and to 40 for those at increased risk, from 1 July 2026.
- Ontario Health (Cancer Care Ontario). Frequently asked questions for primary care providers: ColonCancerCheck program changes, version 1.0, 2026. One first-degree relative diagnosed at 60+ now screens with FIT every 2 years; increased-risk interval 5 years for everyone; don't repeat FIT after an abnormal result; not for people with symptoms; no routine screening after 74 (75–85 individual decision; not over 85); hereditary syndromes (FAP, Lynch) not screened by the program; OHIP required.
- Ontario Health (Cancer Care Ontario). ColonCancerCheck guide to colorectal cancer screening in Ontario (provider tool), 2026. Program is for people with no symptoms and OHIP coverage. Polyps needing surveillance or past CRC: follow surveillance guidelines; long-standing colonic Crohn's or UC, or hereditary syndrome: refer to specialist.
- Ontario College of Family Physicians. ColonCancerCheck: key changes in effect on July 1, 2026. June 2026. Summary of Ontario Health changes: start at 45 (average) and 40 (increased risk); one relative at 60+ is average risk; stop at 74, 75–85 by choice, 86+ against; In-Common Laboratories now sends and tests FIT kits; FIT steps in English and French in the kit and in 35+ more languages at ontariohealth.ca/fitinstructions; reminder letter if not returned in 2 months.
- Ontario Health (Cancer Care Ontario). Abnormal FIT result: frequently asked questions. Only a colonoscopy can tell if you have cancer; FIT can't tell bleeding from cancer apart from other causes such as hemorrhoids; after an abnormal FIT and a normal colonoscopy, wait 10 years.
This guide is for general education. It can't replace advice from your own care team, who know your health history.