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Colorectal Cancer Screening

Colorectal cancer is the top 3 leading cancer-related death in Singapore.
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What is Colorectal Cancer?

Colorectal cancer is the top 3 leading cancer-related death in Singapore. It is the most common type of cancer seen in men and the second most common type of cancer seen in women in the country. Routine screening will promise early detection and a higher likelihood of recovery.

Colorectal cancer, also interchangeably referred to as colon cancer, is a type of cancer that affects the colon (the large intestine) and the rectum (the connection tube of the colon and anus). Colorectal cancer takes years to develop. Prior to the manifestation of cancer, a non-cancerous polyp may grow over the inner lining of the affected intestine.

During the initial phase of colorectal cancer, the cancer cells grow within the colonic lining wall. Over time, the cancer cells will spread and invade nearby tissues, intestines, or lymph nodes. The cancer cells may also travel to nearby organs via the adjacent bloodstream and lymphatic drainage causing secondary cancer cell deposition (also known as ‘metastasis’). Colorectal cancers have the tendency of spreading to other organs such as the lungs, liver, and brain, in a process often referred to as distant metastasis.

What Causes Colorectal Cancer?

Very much like other types of cancer, it is still unclear what exactly causes colorectal cancer. Fundamentally, colorectal cancer occurs due to a genetic mutation in one’s DNA (deoxyribonucleic acid) subsequently causing the proliferation of cells. However, it is worth noting that there are certain risk factors that can increase your probability of developing colorectal cancer.

What are the symptoms of colorectal cancer?

Patients with colorectal cancer may have insidious (not obvious or noticeable) symptoms during the early stages. Symptoms may also vary depending on the exact site of cancer development.

As colorectal cancer progresses one may present with:

Rectal bleeding
Blood in the stools also known as rectal bleeding
Change of bowel habits – including constipation or diarrhoea
Palpable lump/mass over the abdomen
Unintentional weight loss
Noticeable reduction in energy levels
Abdominal symptoms such as abdominal bloatedness, stomach cramps. or pain
Rectal bleeding
Blood in the stools also known as rectal bleeding
Change of bowel habits – including constipation or diarrhoea
Unintentional weight loss
Noticeable reduction in energy levels
Abdominal symptoms such as abdominal bloatedness, stomach cramps. or pain
Palpable lump/mass over the abdomen

Is Ovarian Colorectal Painful?

Colorectal pain can be painful and is either often or recurring. It is important to remember that pain is not a state that is normal to the human body, so being proactive and aware is vital in obtaining a diagnosis of colorectal cancer. These pain may manifest as pain caused by gassiness, pain on the rectum when sitting, pain accompanied by bleeding when defecating, or excruciating and sudden abdominal pain.

Sexual Health Screening

STD screening tests generally involve blood tests, swab tests and urine tests.

Dr Ben Medical offers STD screening for commonly sexually transmitting conditions such as Chlamydia, Gonorrhea, warts, herpes, HIV, Syphilis and other more – highlighted comprehensively in our packages.

We also offer long term sexual health care and services:

  • Sexual health advice for patient and partners
  • Cervical cancer screening with pap smear, HPV testing
  • Cervical cancer vaccination

Who is at Risk of Colorectal Cancer in Singapore?

There are several factors that increase a person’s risk of developing colorectal cancer, these are:

  • Age: colorectal cancer tends to start developing among older patients (50 years and above). 
  • Diets: patients with diets that are high in fat and low in fibre tend to be prone to colorectal cancer. Excessive red meat consumption also increases one’s risk. 
  • Habits: smokers and high-alcohol consumers have an increased risk of colorectal cancer. 
  • Other health conditions: conditions such as inflammatory bowel disease, history of colon polyps, endometrial cancer, and obesity predisposes one to colorectal cancer. 
  • Family history: individuals with a family history of colon cancer or polyps have an increased chance of developing colorectal cancer. 

Genetics: genetic conditions such as  Lynch Syndrome, and familial adenomatous polyposis (FAP) increases an individuals risk of developing colon cancer.

How is Colorectal Cancer Diagnosed?

There are a variety of tests that you may be required to undergo depending on your condition and severity. It is important that a thorough screening approach for individuals of all ages is taken to prevent the event of undetected cancer probabilities. 

  • Medical review: involves an analysis of family history, any symptoms if present, and establishing a baseline of your health with prior screening results. 
  • Blood test: especially if blood in stools is present as it helps identify if patients are anaemic. Blood tests would also be necessary to identify the presence of colorectal cancer antigens such as the carcinoembryonic antigen (CEA). 
  • Faecal occult blood test (FOBT): stool sample will be collected to determine the presence of blood.
  • Colonoscopy: typically conducted by a gastroenterologist to visualise the internal lining of the intestine. A colonoscopy is recommended as part of the colon cancer screening programme from the age of 50 years onwards (even if asymptomatic). This screening is done at an interval of 5-10 years. A biopsy may be conducted if polyps are present.

Sexual Health Screening

STD screening tests generally involve blood tests, swab tests and urine tests.

Dr Ben Medical offers STD screening for commonly sexually transmitting conditions such as Chlamydia, Gonorrhea, warts, herpes, HIV, Syphilis and other more – highlighted comprehensively in our packages.

We also offer long term sexual health care and services:

  • Sexual health advice for patient and partners
  • Cervical cancer screening with pap smear, HPV testing
  • Cervical cancer vaccination

What are the Treatment Options for Colorectal Cancer in Singapore?

If suspected of colorectal cancer during screening, you will be referred to a specialist. Colorectal cancer patients are managed by a multidisciplinary medical team of doctors including gastroenterologists, colorectal surgeons, oncologists (both radiation oncologist and medical oncologist), nurse practitioners, nutritionists, and other health professionals depending on the individual’s condition.

Treatment of colorectal cancer varies depending on the cancer stage. These may include surgery, radiofrequency ablation, cryosurgery, chemotherapy, radiation therapy, targeted gene therapy, and immunotherapy. The treatment goal (curative or palliative) should be discussed with your doctor. The potential side effects of the treatment should also be discussed so that you can make an informed decision to suit your needs.

Frequently Asked Questions

You can prevent colon cancer by not smoking, consuming a healthy diet which is rich in fibre, practising moderation in the consumption of fatty foods and red meats, and cutting down on alcohol. However, it is pertinent to remember that even the healthiest of individuals may be at risk of colorectal cancer. Fundamentally, a screening is your best bet to mitigate the risks of colorectal cancer.
You are advised to speak to your doctor (family physician or your gastroenterologist). As a general guide, if you have a family history of a first-degree relative (parents or siblings) who have been diagnosed with colorectal cancer, you are advised to consider colonoscopy screening 10 years before the age of their diagnosis. You are encouraged to speak to your doctor, as your doctor will also need to factor in other individual risk factors (lifestyle, background underlying medical history) as well.

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