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Colorectal Cancer Standards

For the past few years, Cancer Care Nova Scotia (CCNS) has been working with health professionals, administrators, and patient representatives to develop clinical standards for cancer care in Nova Scotia. The Colorectal Cancer Diagnosis and Referral Standards Working Group has developed this draft clinical standard.

What is a clinical standard?
A clinical standard provides doctors and all other health care professionals with clear direction about the kind of tests and treatments needed for a certain cancers, where they need to take place and in what timeframe they need to occur to ensure patients receive high quality care, based on the latest evidence.

Standards may also indicate necessary continuing education or training health professionals need, hospital equipment and staffing requirements. Standards are also written so that patients know what to ask for and expect from the health care system in the course of their own care. Once implemented, a standard must be followed by everyone involved. As an example, a standard might indicate that someone with a certain cancer should have a CT scan before surgery.

Clinical standards will enhance and improve cancer care and health for Nova Scotia patients and families.

Hearing from patients and families
Cancer patients, survivors and their families have a valuable role to play in the development of clinical standards because they have experienced the system first-hand. They know the issues that are important. CCNS has committed to involving cancer patients, survivors, and family members in our standards development work. Anyone with experience of colorectal cancer (whether personally or as a family member) can help to review the draft clinical standard.


Colorectal Cancer Diagnosis and Referral Standards
The draft Colorectal Cancer Diagnosis and Referral Standards are designed to support and guide healthcare providers and patients during the diagnostic period. The diagnostic period is from the time a person first visits a doctor or nurse practitioner with symptoms or warning signs that might indicate colorectal cancer through until a person is told they definitively have cancer. The diagnostic period also applies when someone has a positive screening test for colorectal cancer. In this case, the diagnostic period begins from their positive test result, until the patient is told they have cancer.

There are many ways that people are diagnosed with colorectal cancer:

• Some people are symptomatic, meaning they have symptoms or warning signs and visit a Doctor, Nurse Practitioner, or the Emergency Room

• Some people have no symptoms, but do a screening test either through the Colon Cancer Prevention Program (that is, they received a FIT kit in the mail), or their doctor might have given them a FOBT or a colonoscopy

• Some people have no symptoms, but learn they have colorectal cancer as a result of other tests for a different health problem

The draft standard has two parts.

• The first section of the Colorectal Cancer Diagnosis and Referral Standards addresses the work up and referral steps that should be taken for patients who have warning signs or symptoms. We invite colorectal cancer patients and survivors who had symptoms or warning signs before they were diagnosed or their family members to review this section of the standards. Click here to read this section.

• The second section of the Standards outlines how health professionals should communicate with patients to let them know of their diagnosis. We ask all colorectal cancer patients and survivors and their family members to review this section. Click here to read this section.

The full document with references can be accessed here. You do not have to look at every aspect of the standard.

How you can contribute:
As colorectal cancer patients, survivors and family members, your experience, your thoughts and comments are important to ensure we create colorectal cancer diagnosis and referral standards that meet the needs of Nova Scotians.

We know that the diagnostic period and receiving a diagnosis of cancer can be very stressful and difficult. We do not mean to cause you any distress when you think back to this time. We appreciate that you are willing to take the time to give us your thoughts so that we can make this period less stressful for future patients. If participating in this survey causes you distress, please contact Jill Petrella at 902-473-2936, toll-free at 1-866-599-2267 (Monday-Friday 9:00-5:00), and she will put you in touch with a local support service.

There are two ways you can help us:
1. Online Survey: With a computer and access to the internet, you can do this from home. The survey works best with Internet Explorer.

To complete the survey 

• First, please read through the document “A Guide for Patients and Families” – this will provide you with some background information – what we’re doing, and why, as well as questions to consider as you read through the document.

• Next, review the applicable sections of the Colorectal Cancer Diagnosis and Referral standards. It’s important to remember that the clinical standards have been written for use by health professionals, so some of the words and concepts will be technical in nature. We do not expect you to have any clinical knowledge – your experience as a patient/family member provides you with a unique perspective to share.

You may find it helpful to focus your review on the sections related to your experience:
Work up and Referral section for patients and survivors who had symptoms or warning signs before they were diagnosed

Communicating the diagnosis for all colorectal cancer patients and survivors

• You may now complete the online survey, by clicking “here.”

Please note the survey closes October 13.


2. Focus Group:
Review the draft standards and participate in a focus group. Registration deadline is Friday, October 3. Spaces are limited.

Focus groups will be held in: 
    • Halifax, Wednesday October 8 9:30-11:30 
    • Truro, Wednesday October 8 2:00 – 4:00 
    • Sydney, Thursday, October 9 10:00-12:00


To register for the focus groups, please call Jill Petrella at 902-473-2936/
1-866-599-2267 or email ccns.nshealth.ca by October 3.

If you are interested in the focus groups but don’t live in Halifax, Sydney or Truro, please contact Jill Petrella to discuss.

You can choose to participate in the online survey, focus group, or both. If you choose to participate in the focus group, you will be asked to review the draft standards prior to your participation in the session.

If you are unable to participate in the online survey or focus groups, and wish to contribute, please contact Jill Petrella and we will arrange for your input to be included.

Supporting documents
Clinical Standards (complete document)
• Colorectal Cancer Diagnosis and Referral Standards Review: A guide for patients and families
Cancer Patient Family Network Registration. Joining the CPFN means that you will be notified whenever there are opportunities like this for cancer patients/survivors/family members to help improve the cancer system in Nova Scotia.

How will your contribution be used?
A summary of the responses of everyone who reviews the standard will be given to the Working Group for its consideration. Your name and contact information will be kept confidential. The summary will not identify who gave what information. A summary of the feedback received, along with the final clinical standards will be available on the Cancer Care Nova Scotia website.

Questions, comments or need some help?

If you would like to talk about this in more detail or if you have any questions or concerns, please connect with Jill Petrella, 902 473-2936 or toll free 1-866-599-2267 or by email at ccns.nshealth.ca  

Thank you for your time and support.