Colorectal Cancer Screening in Singapore: When Should You Start?
Colorectal cancer is one of the more commonly diagnosed cancers in Singapore. Screening may help identify colorectal cancer at an earlier stage or detect polyps that could develop into cancer over time.
Understanding when colorectal cancer screening may be recommended can help individuals discuss appropriate screening options with their healthcare provider.
What Is Colorectal Cancer Screening?
Colorectal cancer screening refers to tests used to look for signs of cancer or pre-cancerous growths in the colon or rectum before symptoms appear.
Screening may involve:
- Stool-based tests
- Colonoscopy
- Imaging tests in selected cases
Different screening methods may be recommended depending on a person’s age, medical history, family history, and risk factors.
Why Colorectal Cancer Screening Matters
Colorectal cancer may develop gradually over several years. In some patients, polyps may form in the colon or rectum before becoming cancerous.
Because early colorectal cancer may not cause symptoms, screening may help detect abnormalities before they progress further.
Patients diagnosed at different stages of colorectal cancer may require different treatment approaches, which can include monitoring, removal of polyps, or procedures such as colorectal cancer surgery depending on the condition identified.
When Should Screening Start?
In Singapore, colorectal cancer screening is commonly recommended for adults aged 50 years and above who are considered at average risk.
However, some individuals may require earlier screening, including those with:
- A family history of colorectal cancer
- A personal history of colon polyps
- Inflammatory bowel disease
- Certain inherited conditions associated with colorectal cancer risk
The appropriate starting age and screening interval can vary between individuals.
Common Colorectal Cancer Screening Tests
Faecal Immunochemical Test (FIT)
The FIT test checks for hidden blood in the stool that may not be visible to the naked eye.
This test is commonly used as an initial screening method and is generally performed yearly or at intervals recommended by a healthcare provider.
A positive FIT result does not confirm cancer but may require further evaluation with colonoscopy.
Colonoscopy
Colonoscopy allows a doctor to examine the inside of the colon and rectum using a flexible camera.
During the procedure, polyps or abnormal tissue may sometimes be removed or biopsied for further analysis.
Colonoscopy may be recommended for:
- Patients with symptoms
- Patients with positive stool tests
- Individuals with increased colorectal cancer risk
- Follow-up surveillance after previous findings
Symptoms That May Need Medical Review
Although screening is intended for individuals without symptoms, some symptoms may still require evaluation regardless of age.
These can include:
- Blood in the stool
- Changes in bowel habits
- Unexplained weight loss
- Persistent abdominal discomfort
- Ongoing fatigue or anaemia
Patients experiencing these symptoms may require further assessment to determine the cause.
Colorectal Cancer Risk Factors
Several factors may influence colorectal cancer risk, including:
- Increasing age
- Family history of colorectal cancer
- Smoking
- Obesity
- Low physical activity
- Diets high in processed meats
- Certain gastrointestinal conditions
Having risk factors does not mean a person will develop colorectal cancer, but screening recommendations may differ depending on individual circumstances.
What Happens If Screening Finds Abnormalities?
If abnormalities are detected during screening, further investigations may be recommended.
This can include:
- Additional imaging
- Biopsy
- Polyp removal
- Referral to a specialist
Management options depend on the findings and stage of the condition. In some patients, treatment planning may involve discussions regarding surveillance, endoscopic procedures, or colorectal cancer surgery.
Discussing Screening With a Colorectal Cancer Specialist
The most appropriate colorectal cancer screening approach may vary based on age, personal medical history, symptoms, and family history.
Patients with questions about colorectal cancer screening, colonoscopy, or colorectal cancer surgery may benefit from discussing their concerns with a qualified healthcare professional experienced in colorectal conditions.
