Colorectal Cancer Screening Protocol

Colorectal cancer is the number one cancer in Singapore. And over the last three decades, the incidence has increased dramatically. Based on statistics from the world cancer research fund, colorectal cancer is the third most common cancer worldwide with 1.8million new cases in 2018.

You can learn more about colorectal cancer – the risk factors and symptoms here. In this article we will discuss in depth the types of screening available to detect colorectal cancer. 

Importance of screening

We know that the incidence of colorectal cancer is rising, we also know that most of colorectal cancers are asymptomatic or silent. As such the role of screening becomes very important in detection of early stage cancer. The earlier we can detect it, the higher the chance of cure.

The national wide colorectal screening in Singapore starts from the age of 50 for the general population. The US CDC recommends it from age 45 onwards.

Types of Screening

Health Promotion Board Singapore recommends yearly

- Fecal immunochemical test ( FIT ), or

- Fecal occult blood test ( FOBT ), or

- Colonoscopy once every 5 years.

FIT Test

It is a newer technology and is more specific for blood from the colon. It detects the globin part of human red blood cell and is able to differentiate human blood and animal blood in our diet.

Swipe the tip left and right, up and down over the surface of the stool. Cap it back and shake a few times. Return the bottle back to your doctor.

FOBT Test

It detects the heme component of blood, so it can also detect blood from the upper part of our digestive system like the stomach, but however, it can possibly detect animal blood in our diet too, which makes it theoretically not be as accurate as the FIT kit.

Scoop 1-2 scoops of your fecal material and cap it back. Then pass this container back to your doctor.

We would encourage patients to get two separate samples. If any one of the sample is positive, we would then refer to a specialist for a colonoscopy for evaluation to exclude cancer.

This test is painless and its not invasive at all - so please get it done if you are in the appropriate age group.

Colonoscopy

It is a test that has to be done by a specialist under sedation. It involves inserting a camera up the rear end for direct visualisation of the rectum and the entire length of the colon.

It is both diagnostic and therapeutic - if polyps are seen during the procedure, they can be removed. If the colonoscopy reflects normal results , then nothing needs to be done for the next 5 years.

It is more expensive and invasive than the two stool tests mentioned. In any case, do consult your family doctor to decide which test is suitable for you.