Colorectal Cancer or Colon Cancer is one of the most common cancers in Singapore. It is the top cancer among males, with male Chinese Singaporeans particularly at risk. For females, colorectal cancer falls as the second most common cancer. From 2016-2020, colorectal cancer is the second leading cause for cancer deaths in Singapore for both genders with 14.4% of cancer deaths in males and 15.4% in females.
The average population risk for developing colorectal cancer in Singapore is among the highest in the world. Despite this, the survival rate for colorectal cancer in Singapore is improving over the years and is attributed to improved medical technology and early detection with the help of colorectal cancer screening in Singapore.
Colorectal cancer typically begins with adenomatous polyps in the inner lining of colon or rectum that overtime, may turn cancerous. This type of polyp are relatively asymptomatic. Early detection with the help of colorectal cancer screening and removal of these polyps can help reduce the risk for colorectal cancer.
Who Should Be Screened for Colorectal Cancer
The risk of having a colorectal cancer rises with age. Colorectal cancer screening is advisable for individuals above 50 years old belonging to the average-risk factor and earlier for individuals at increased risk.
The following table is based on MOH guidelines for colorectal cancer screening using colonoscopy in Singapore:
| Risk Group | Who are in this risk group | Onset (Age, Years) | Frequency |
| Average-Risk | Asymptomatic, or family history limited to non-first degree relatives. | 50 years. | 10 years. |
| High Risk | Colorectal cancer in the first degree relative age 60 years or younger, or two or more first-degree relatives. | 10 years prior to the youngest case in the family or age 40 years, whichever is earlier. | Every 5 Years |
| Colorectal cancer in the first degree relative over the age of 60 years. | 50 years. | Every 10 Years | |
| Personal history of colorectal polyps. | 1 to 3 years after polypectomy in the presence of high-risk features (>1cm, multiple, villous architecture); otherwise, 3 to 5 years after polypectomy for low-risk polyps | ||
| Personal history of colorectal malignancy. | One year after resection. | Every 1 to 3 years. | |
| Personal history of ovarian or endometrial cancer. | After resection. | ||
| Very High Risk | A family history of hereditary non-polyposis colorectal cancer. | 20 to 25 years. | Every 1 to 2 years. |
| Inflammatory bowel disease. left-sided colon. pan-colitis. | a. From 15th year of diagnosis onwards. b. From 8th year of diagnosis onwards. | a. Every 1 to 2 years. b. Every 1 to 2 years. |
How to Screen for Colorectal Cancer In Singapore
There are various screening tests available for colorectal cancer screening in Singapore such as:
- Faecal occult blood test (FOBT)
- Colonoscopy
- Flexible sigmoidoscopy
- Computed Tomographic Colonography
- Double Contrast Barium Enema
Among these screening tests, colonoscopy is considered as the gold standard for diagnosis. It can provide patients with an accurate assessment of the colon. Colonoscopy also allows detection and removal of polyps which is not possible with other modalities of colorectal cancer screening.
A colonoscopy procedure involves using an endoscope, a tube with a tiny camera and light on the end that is guided through the colon. Preparation like a special diet, taking laxatives, fasting for a certain period of time, and sedatives are needed before a colonoscopy procedure.
Where to Screen for Colorectal Cancer In Singapore, Malaysia and Thailand
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This article is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.