Cancer Screening & Adult Vaccination in Ontario

Cancer Screening & Adult Vaccination in Ontario

Ontario Health (Cancer Care Ontario) runs province-wide organized screening programs for 4 types of cancer: lung, breast, cervical and colorectal (commonly called “colon cancer” or “bowel cancer”).

Cervical Cancer Screening Programme: Females age 21 to 69 upon initiation of sexual activity every three years.

Regular Pap tests can detect changes in the cells of the cervix before they become cancerous. Catching these changes early (and treating them, if necessary) can prevent cervical cancer.

Colorectal Cancer Screening Programme: Age 50 to 74

Colorectal cancer screening increases the chance of finding cancer early when it is more likely to be cured. When colorectal cancer is caught early, 9 out of 10 people can be cured.

The kind of screening test you get depends on whether you are at average risk of getting colorectal cancer or at increased risk of getting colorectal cancer.

Someone is at average risk if they are 50 to 74 years old with no first-degree relative (parent, brother, sister or child) who has been diagnosed with colorectal cancer. Test of choice would be a 2 yearly FIT ( stool sample for blood ) test.

Someone is at increased risk if they have a family history of colorectal cancer that includes 1 or more first-degree relatives (parent, brother, sister or child) with the disease.Test of choice would be a colonoscopy either every 10 years ( if diagnosed above age 60 ) or every 5 years ( if diagnosed before age 60) commencing at age 50 or ten years before age of diagnosis, whichever is earlier.

Breast Cancer Screening Programme: Females age 50 to 74 every two years

Women at average risk receive a Mammogram every two years 

Women ages 30 to 69 who meet the High Risk Ontario Breast Screening Program eligibility criteria get screened every year with both mammography and breast magnetic resonance imaging (MRI) (or screening breast ultrasound if MRI is not medically appropriate) patients at high risk 

• Are known to have a gene mutation that increases their risk for breast cancer (e.g. BRCA1, BRCA2, TP53, PTEN, CDH1)
• Are first-degree relatives (parent, brother, sister or child) of someone who has a gene mutation that increases their risk for breast cancer (e.g. BRCA1, BRCA2, TP53, PTEN, CDH1), have already had genetic counselling and have chosen not to have genetic testing
• Have been assessed by a genetics clinic (using the IBIS or BOADICEA tools) as having a 25% or greater lifetime risk of breast cancer based on personal family history
• Have had radiation therapy to the chest to treat another cancer or condition (e.g., Hodgkin lymphoma) before age 30 and at least 8 years ago

Women who are concerned that they may be high risk can be referred to Genetic Counselling and testing clinic for assessment.

Lung Cancer Screening Program is Ontario’s organized screening program for people at high risk of getting lung cancer. This is done through annual Low Dose CT scan of chest.

People may qualify for lung cancer screening if they meet the referral inclusion criteria:

• are 55 to 74 years old, and
• have smoked cigarettes every day for at least 20 years

https://www.cancercareontario.ca/en/cancer-care-ontario/programs/screening-programs

 

 

 

Adult Vaccination:

 

 

Influenza / Flu Vaccine is offered during Flu season every year to individuals age 6 months and above usually during

Pharmacies are able to administer the vaccine to children age two and above. Patients can locate a provider using this search engine

http://www.health.gov.on.ca/en/common/system/services/phu/locations.aspx

Note that the vaccine administered to those age 65 and above is a higher dose version.  

https://www.toronto.ca/community-people/health-wellness-care/information-for-healthcare-professionals/immunization-and-vaccine-info-for-health-professionals/

 

 

Tetanus & Diphtheria Vaccination

 

 Adults should get Td vaccine boosters every 10 years for continued protection.

 

One of these boosters during adulthood should also contain Pertussis / Whooping cough vaccine. So here TD Vaccine would be be replaced by TDaP ( Adacel ) 

Pneumonia Vaccine

There are two types of Pneumoccoccal Vaccines which are licensed from age 50 in adults. 

Prevnar 13 is approved from age 50 and is available privately. This a newer longer lasting 'conjugate' vaccine currently not covered under OHIP. 

Pneumovax 23 is approved from age 50 and available on OHIP from age 65. 

 

High risk patients with following conditions

• Asplenia or sickle cell disease
• Hepatic cirrhosis
• Chronic renal failure or nephrotic syndrome
• HIV
• Immunosuppression related to disease or therapy 

can receive a single dose of Prevnar13 on OHIP. These patients can also receive the Pneumovax23 vaccine earlier on OHIP as well as receive an additional booster dose after five years.

For maximum protection, patients should ideally receive both Prevnar 13 as well as Pneumovax 23. The gap between these needs to be a minimum of two months if Prevnar 13 administered first or twelve months if Pneumovax 23 administered first. 

Shingles Vaccine is licensed from age 50 as two injections administered 2-6 months apart. OHIP covers this vaccine from age 65 to 70. Patients who received the previous ( Zostavax ) vaccine can also take Shingrix which is a newer more effective vaccine. 

INFORMATION & DISCLAIMER: 

I obtained my primary medical education from India and post graduate MD in Family Medicine from the United Kingdom. After working in National Health Service, England for 15 years, I moved to  Canada five years ago.  As a Family Physician, I consider my speciality as engaging patients, interpreting medical information for them, guiding them through their health journey, promoting wise health choices and encouraging early detection and management of disease. 

The information on this blog is accurate as per time of publishing. Scientific information and evidence changes dynamically and my opinions would change accordingly. 

The recommendations on this blog are not prescriptions and any patients considering these should consult with a physician to check if these are applicable to their unique situation.

 

Physician websites I commonly use for reference include 

https://www.medscape.com/familymedicine 

https://gpnotebook.com/homepage.cfm

 

https://www.guidelinesinpractice.co.uk/ 

 

Patient reference websites I commonly recommend to patients include

 

https://www.aboutkidshealth.ca/ 

https://www.mayoclinic.org/patient-care-and-health-information

 

https://www.webmd.com/a-to-z-guides/common-topics 

 

https://patient.info/

Patient confidentiality must be upheld at all times and any patients wishing to discuss specific medical scenarios on social media are requested to do so anonymously in 'third party' sense. 

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