Alberta Cancer Foundation

Ask the Expert

Q: “My grandfather died from colorectal cancer when he was in his 60s. I’m 45 years old now. Do I need to start getting screened for colorectal cancer?”

According to Dr. Huiming Yang, director of cancer screening programs for Alberta Health Services, colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer-related death for men and women combined in Alberta. Since this type of cancer often has no signs or symptoms, screening is the only way to detect it at an early stage. When it is caught early, 90 per cent of cases can be successfully treated.

“There are several factors that determine when a patient should begin screening for colorectal cancer,” says Yang. “Although each case is unique, Alberta Health Services has developed recommendations to help doctors decide how best to screen for colorectal cancer.”

There are three major factors that affect an individual’s risk of getting colorectal cancer: age, personal medical history and family history. Based on these three factors, a family physician determines whether a patient is at low risk, average risk, moderate risk, or high risk for developing colorectal cancer. An individual’s risk determines when screening should be started, what type of screening tests should be used and how often testing should be done.

It is recommended that everyone aged 50 to 74 should be screened for colorectal cancer every one or two years using a fecal occult blood test, a simple test that looks for blood in the stool. If a patient has a moderate or high risk of contracting colorectal cancer, screening should begin at a younger age and include other forms of testing such as colonoscopy, a procedure used to see inside the colon and rectum.

“In this particular scenario, a person whose grandfather died from colorectal cancer in his 60s would still be considered to be at average risk for the disease, so typically in Alberta they would begin testing at age 50 with an annual fecal occult blood test,” explained Yang. “You are considered to be at moderate risk if you have a first degree relative (that means a father, mother, sibling, or child) who was diagnosed with a non-hereditary form of colorectal cancer at less than 60 years of age. Since this was a grandfather who was older than 60 at the time of his diagnosis, this person would still be considered at average risk.”

Yang points out that it is always a good idea to talk to your family doctor about your particular circumstances, because each case is unique. Your doctor can determine when to begin screening and which tests are appropriate for you. “Don’t put off being screened for colorectal cancer,” he urged. “It is a deadly cancer that can be prevented and successfully treated if it is caught early.”

Go online to find out more about risk levels and screening tests for colorectal cancer. Visit:

Q: “I used to smoke a pack of cigarettes a day, but I’ve cut back and I’m down to a couple of cigarettes a day. Does this reduce my cancer risk?”

Dr. Charles Butts, a medical oncologist specializing in lung tumors and lung cancer research, replies: “Reducing smoking is an important step on the road to quitting completely,” says Butts. “While there may be some cardiovascular benefits to reducing the amount you smoke, studies have shown that if you want to reduce your risk of dying from lung cancer, you need to stop smoking completely.”

A large study of more than 50,000 heavy smokers was undertaken in Norway to determine if men and women who reduced their daily cigarette consumption by greater than 50 per cent would also reduce their risk of dying from smoking-related diseases, or any other cause. Individuals were screened and were followed for more than 25 years. Long-term follow up showed that reduction in consumption did not reduce the risk of premature death significantly.

On the other hand, other studies have shown that stopping smoking at any age reduces the risk of death from lung cancer. The sooner a person completely stops smoking, the greater the benefit.

There are many smoking cessation aids available, as well as support initiatives to help people in their efforts to stop smoking. Individuals should talk to their family doctor about their specific situation, so they can create their own plan to quit smoking.

“If someone has gotten down to smoking just a few cigarettes per day, they should be encouraged to completely stop,” Butts recommends. “It’s never too late to reap the benefits of smoking cessation.”

Alberta Health Services offers a number of free smoking cessation programs and clinics. To find out more, visit and look for addictions and substance abuse under the programs and services section of the website.

Ask the Expert is an opportunity to have your questions regarding cancer prevention and treatment answered by an expert at Alberta Health Services. We’ll answer different reader-submitted questions in each issue of Leap; please submit them via email to Remember, the advice below is never a substitute for talking directly to your family doctor.
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