Colorectal cancer (CRC) is the most common type of Cancer in Singapore. Male Chinese Singaporeans are, particularly at risk. Surgery is the mainstay of treatment for colorectal cancer. Early diagnosis improves the likelihood of a cure
Most cases of colorectal cancer arise from polyps. Transformation from a polyp to cancer proceeds along a well established 5-10 year trajectory. Polyps are asymptomatic, and present in up to 25% of individuals at age 50. If detected early, polyps can be removed easily and progression to cancer can be nipped in the bud. Hence, the importance of early screening and management is paramount.
How do I screen myself for colorectal cancer?
- Colonoscopy (The Gold Standard)
- Colonoscopy involves insertion of a flexible camera into the rectum to look at the large intestine from the inside.
- This is done by a specialist (General surgeon or gastroenterologist), in a monitored setting where light sedation is provided.
- The table below explains the recommendation for when to start , and how frequent , to get your colonoscopy done.
| Risk Group | Screening Tool | Onset (Age, Years) | Frequency |
| A. Average Risk | |||
| Asymptomatic or family history limited to non-first degree relatives (screening tool alternatives in order of supporting evidence) | Colonscopy | 50 years | Every 5 to 10 years |
| B. High Risk | |||
| Colorectal cancer in the first degree relative age 60 years or younger or two or more first-degree relatives | Colonoscopy | 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 | Colonoscopy | 50 years | Every 10 Years |
| Personal history of colorectal polyps | Colonoscopy | 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 | Colonoscopy | One year after resection | Every 1 to 3 years |
| Personal history of ovarian or endometrial cancer | Colonoscopy | After resection | |
| C. Very High Risk | |||
| A family history of familial adenomatous polyposis | Flexible sigmoidoscopy consider genetic counselling and testing | 10 to 12 years (from puberty) | Annually |
| A family history of hereditary non-polyposis colorectal cancer | Colonoscopy, consider genetic counselling and testing | 20 to 25 years | Every 1 to 2 years |
| Inflammatory bowel diseaseleft-sided colonpan-colitis | Colonoscopy Colonoscopy | From 15th year of diagnosis onwards From 8th year of diagnosis onwards | Every 1 to 2 years Every 1 to |
2. Faecal Immunochemical Test (FIT)
- Frequency: Once a year.
- What it is: A non-invasive test that detects hidden blood in the stool, which can be an early sign of colorectal cancer or polyps. Two stool samples are obtained at least 24 hours apart and submitted to the laboratory
- Advantages: Easy to perform at home, cost-effective, and widely available.
- Follow-up: If either FIT result is positive, a colonoscopy is recommended for further evaluation.
- FIT testing is also part of the national SFL Programme – and is available free (for citizens) yearly, from the age of 50, at your Healthier SG Clinic.
3. Tumour Markers : e.g CEA
- Tumour markers such as Carcinoembryonic antigen (CEA) are commonly done as a easy, non-invasive way to screen for colorectal cancer.
- These are included in many of our health screening packages.
- However, be aware that there may be a high incidence of false negative and/or false positives with this test.
- If this test were to be elevated, the next step would be to go for a colonoscopy.
4. CT Colonography (Virtual Colonoscopy): A less invasive imaging test that can be used for those who cannot undergo a standard colonoscopy.
- This involves administering contrast agent into the rectum before going for a CT-scan.
- This is an alternative to colonoscopy for those who cannot tolerate the risks of a colonoscopy (e.g very weak heart).
Colorectal Cancer Screening with AMG
At AMG, most of our health screening package include FIT testing, and we also can perform subsidised yearly FIT testing for eligible Singaporeans/PRs under Healthier SG.
If you require, we can also refer you to a private or public specialist for screening colonoscopy.
Make an appointment today to speak to our doctors to find our what is most appropriate for you.