The New Brunswick Colon Cancer Screening Program: Are above-average-risk New Brunswick residents falling through the cracks?

The New Brunswick Colon Cancer Screening Program (NBCCSP) rejects individuals deemed above average risk for colorectal cancer (CRC) on the presumption that screening will occur via primary care providers. We examined the CRC screening outcomes among a retrospective cohort of patients deemed not average risk (NAR) and rejected from the NBCCSP. Within a randomly selected subset of 191 NAR patients with accessible data and no prior CRC screening, 120 (62.8%) remained unscreened at the end of the study period. In a matched case-control study, NAR patients who received colonoscopies waited nearly a year longer than average-risk individuals. Furthermore, NAR patients also waited significantly longer for a diagnosis of cancer compared to average-risk patients. Above-average-risk patients would benefit from expanded programmatic screening of the NBCCSP.