Cancer Care Program

Comprehensive information about cancer prevention, screening, treatment, and care for Nova Scotians.

About Screening

About 6,000 Nova Scotians are diagnosed each year with cancer. However, many cancers can be prevented or found early, when treatment is most effective.

Nova Scotia Health Authority's Cancer Care Program is working with partners to influence policy and planning that makes it easier for Nova Scotians to adopt healthy lifestyles, such as:

  • Not smoking
  • Being physically active
  • Limiting alcoholic drinks
  • Limiting salt in your diet
  • Limiting the amount of red and processed meats in your diet
  • Avoiding tanning beds and practicing sun safety
  • Participating in cancer screening programs

Cancer screening is about preventing cancer or finding it early, when treatment is most effective, before there are any warning signs. Nova Scotia has three organized cancer screening programs:

  • Cervical Cancer Prevention Program
  • Colon Cancer Prevention Program
  • Breast Screening Program

Breast Screening Program

The Nova Scotia Breast Screening Program provides mammograms (breast X-rays) and information on good breast health care to women ages 50-69.

Statistics show that one out of eight women in Nova Scotia will develop breast cancer in her lifetime. Very early detection of breast cancer improves the chance of a cure. The Nova Scotia Breast Screening Program has been developed to assist in the early detection of breast cancer. The program offers women information on breast health and mammography (breast X-ray).

Cervical Cancer Prevention Program

Cervical cancer is the 9th most common cancer among Canadian women.

What causes cervical cancer?
Cervical cancer is caused by the Human Papillomavirus (HPV). HPV is usually transmitted by sexual contact. More than 75% of women will be exposed to HPV, but only a small number will develop pre-cancer (cervical dysplasia). Regular Pap testing can pick up pre-cancerous changes that can be treated before becoming cancer.

The risk of developing cervical cancer can be reduced by:

  • Using a latex condom
  • Choosing not to smoke 
  • Having a regular Pap test 
  • Not having sex at an early age
  • Limiting the number of sexual partners

The Nova Scotia Cervical Screening Practice Guidelines recommend:

  • Women who have been sexually active* should start having a Pap test at the age of 25. Once women begin having Pap tests, they should have them every 3 years.
  • Women who become sexually active* for the first time after the age of 25 should have a Pap test within three years of the time that they became sexually active.
  • Women who have never been sexually active do not need to have Pap tests until such time as they become sexually active.

* For the purposes of cervical cancer screening, sexual activity refers to vaginal sexual activity which includes vaginal intercourse, vaginal‐oral and/or vaginal‐digital sexual activity, use of shared sex toys/devices.

How often do I need a Pap test?

  • If the Pap test results are normal (negative or clear) women should continue to have Pap tests every three years.

When can I stop having Pap tests?

  • Screening may be discontinued after the age of 70 ONLY if there is an adequate negative screening history in the previous ten years (i.e. three or more negative tests).

Colon Cancer Prevention Program

What is the Colon Cancer Prevention Program (CCPP)?
The Colon Cancer Prevention Program (CCPP) was developed by Nova Scotia Health Authority's Cancer Care Program with the goal of decreasing the number of colon cancer deaths in Nova Scotia by facilitating regular screening of all Nova Scotians aged 50-74. It is available across the province. The CCPP helps find cancer and pre-cancerous growths; if these growths are found early, colon cancer can be prevented.

Is the CCPP working?
It is! More than 8000 Nova Scotians who did the test when they were feeling fine and had no warning signs, were found to have pre-cancerous growths. The growths were removed and cancer was prevented. More than 500 Nova Scotians were found to have a cancer, often diagnosed at an early stage when treatment is most effective.

What information does the CCPP keep?
We keep the information from the Participant Form that people complete with their screening test, the results of the screening test (FIT) so that we know who needs follow-up tests, and the results of any follow-up tests such as a colonoscopy. All of this information will also help us to improve the program over time.

How is my information kept private?
We are required to follow Nova Scotia Health Authority's Privacy Policy. This means that:

  • all program staff are required to protect your privacy.
  • the names of screening participants will not be used in any program evaluation or public reports about the program.

The doctor or nurse that you identified on the Participant Form will receive your results. He or she may ask us for the results of any follow-up tests such as a colonoscopy.

For privacy concerns please contact the Nova Scotia Health Authority Privacy Office at 902-473-2626. To request a paper copy of the policy, please call 1-866-599-2267.

Can I opt out of the CCPP?
Yes. Simply check off the “Opt out” option on the Participant Form that you receive from us in the mail, or call us at 1-866-599-2267. This tells us that you do not want to participate in this program and do not want to be contacted again.

You can rejoin the program at any time simply by calling us at 1-866-599-2267.

How can I find out more about the CCPP?
To learn more about the Colon Cancer Prevention Program, call us toll-free at 1-866-599-2267.

Why does the Participant Form include the question "Are you a member of the following cultural/ethnic communities?"
This information will help us learn, over time, how colon cancer affects people of various cultural/ethnic communities. Evidence suggests that certain communities (for example individuals of African heritage) are at increased risk for developing colon cancer. These specific categories have been selected based on the Nova Scotia cultural competence guidelines and in consultation with other government organizations.

To get invitations/letters from the Colon Cancer Prevention Program, your name and address must be up to date with Nova Scotia's Medical Services Insurance (MSI). To update your information:

What is screening?
Screening can find cancer earlier by testing people who do not show any signs of the disease.

Why is screening for colon cancer important?
Regular screening is important because colon cancer can often develop without any warning signs. The goal is to catch and remove pre-cancerous growths (polyps) early before cancer develops or before it spreads. When found early, colon cancer is preventable and treatable.

How do you screen for colon cancer?
Polyps (growths) in the small intestine often leak small amounts of blood into the stool. A Fecal Immunochemical Test (FIT) can find these small traces of blood. The FIT is a simple test that can be done in the privacy of your home.

Who should be screened for colon cancer?
All healthy people aged 50-74, with no family history of colon cancer, should be screened every two years. Research shows that people aged 50-74 benefit the most from screening for colon cancer.

People with warning signs of colon cancer (such as blood in the stool or changes in bowel habits) and those who have a family history of colon cancer should talk with their doctor who will arrange for the most appropriate screening test based on their history.

How was I chosen to be screened?
Research shows that people aged 50-74 benefit the most from screening for colon cancer. In order to offer this crucial screening program to the people of Nova Scotia, the Nova Scotia Department of Health and Wellness has provided the cancer care program with the names and addresses of people between the ages of 50 and 74 from existing Department of Health and Wellness information sources.

How do I get a screening test?
The Colon Cancer Prevention Program mails screening tests to Nova Scotians aged 50-74 who are registered with MSI.

When will I get my screening test?

Screening kits are mailed weekly based on a person's year of birth and date of birth.

  • If you were born in an even year (e.g. 1950, 1964), you will receive your kit in even years (e.g. 2018, 2020).
  • If you were born in an odd year (e.g. 1951, 1965), you will receive your kit in odd years (e.g. 2019, 2021).
  • You can expect to receive your kit shortly after your birthday.

What is the Fecal Immunochemical Test (FIT)?
The screening kit (FIT) can find tiny amounts of blood that are invisible. The test is easy to do. There is no need to change your diet and you can do the test in your own home.

  • Use the kit to collect a small sample of stool (poop).
  • Mail the sample to the lab, where it is checked for blood.
  • The results will be mailed to you and your doctor or other health care provider.

What does a normal test result mean?

It means that no traces of blood were found in your stool.

Does a normal test mean that I have no abnormal growths in my colon?

No. You may have a polyp that is too small to bleed right now, but it can grow, begin to bleed, and eventually turn into a cancer. It is very important to repeat the test the next time you get a kit in the mail. We will send you a kit every 2 years until you reach the age of 75. The kit will arrive in the mail shortly after you have an 'even' birthday (for example, at ages 56 or 64 or 72).

What does an abnormal test result mean?

An abnormal test means that traces of blood were found in your stool sample, but it does NOT mean you have cancer. In Nova Scotia, 60% of people with an abnormal test have the kind of polyps we are looking for, but very few are found to have cancer. Others with abnormal tests are found to have different causes of bleeding that are likely to need some form of treatment. If blood is found, we will contact you to book a colonoscopy. During this test the lining of the colon is checked to find the cause of the bleeding. If the screening test finds a colon cancer before it causes symptoms, treatment is much more effective.

Do all polyps become cancers?

No. Some kinds of polyps do not become cancers. Not even all adenomas will become a cancer. If we find and remove all the polyps that have a chance of becoming cancer, we can stop cancer before it starts!

Is there anything I can do to prevent colon cancer or to find it at an early stage?

Eat a healthy diet. Don't drink too much alcohol. Limit the amount of red and processed meat you eat. Be physically active. Unfortunately, even the healthiest lifestyle does not provide complete protection. The most effective way to prevent colon cancer, or to find it at an early stage, is the home screening test every 2 years.

What if I do not have any symptoms and no one in my family has colon cancer?

Most Nova Scotians who get colon cancer do not have a family history of the disease. Most people do not have symptoms when the disease is in the early stages. So, if you have no symptoms and no family history, now is the time to take the test!

What if I already have symptoms?

If you have any of the following symptoms, you should see your health care provider:

  • Often see blood mixed with your stool.
  • Have a change in your bowel habit that lasts for more than a few weeks.
  • Have any other worrying symptoms.

ColonoscopyWhat is a colonoscopy?
A long, flexible tube (scope) is slowly guided into your colon through your rectum. You are given medication to keep you from feeling much discomfort. The scope sends a picture of the inside of the colon to a video screen.

A doctor examines the lining of the colon and can remove polyps using tiny tools passed through the scope. For most people, a colonoscopy is a straightforward procedure; however, on rare occasion, some people may have bleeding or other complications such as a perforation (tear) that may require a hospital stay.

Illustration courtesy of CancerCare Manitoba (https://www.cancercare.mb.ca/).

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