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Colorectal cancer develops in the colon or rectum, which together form the large intestine. The colon’s primary function is to absorb water from food and convert waste into stool.
Because colon and rectal cancers share many characteristics, they are collectively referred to as colorectal cancer. Most colorectal cancers originate from benign polyps on the colon or rectum’s inner lining. These polyps can develop into cancer over time, and often present no initial symptoms.
Colorectal cancer can also develop directly from the colon or rectum’s lining, without the development of polyps. Cancer cells can invade the organ wall, extend into surrounding fatty tissue, spread to nearby lymph nodes, and metastasise to distant sites, such as the liver, via the bloodstream.
Colorectal cancer is Singapore’s most prevalent cancer, affecting approximately 45 out of every 100,000 individuals. It is the second most common cancer in men and the second most common in women, after breast cancer. From 2017 to 2021, Singapore recorded 12,239 diagnoses. While most common in those over 50, colorectal cancer incidence is rising among younger individuals, potentially due to hereditary conditions or sporadic cases. Regular screening is crucial for prevention, as it allows for the removal of polyps before they turn into cancer.
#My1stColonoscopy is a campaign organised to provide seamless access to sponsored colonoscopy for individuals aged 45 to 70 from lower-income families. The sponsored colonoscopy includes pre-screen and post-screen consultation with a specialist. By offering this initiative, the campaign aims to ensure that individuals who might otherwise be unable to afford or access colonoscopies can benefit from early detection and treatment of colorectal cancer.
Screening Eligibility Criteria:
- Individuals age 45 to 70 years old
- Valid blue/orange CHAS card or Public Assistance Card
- Individuals that have not done a colonoscopy in the last 5 years
Exclusion Clauses:
- Individuals with Obstructive Sleep Apnea (OSA)
- Individuals with BMI above 35
Signs and Symptoms
Colorectal cancer in its early stages may be undetected due to the absence of symptoms. In later stages, symptoms may include:
- Persistent diarrhoea or constipation
- Blood in stool
- Rectal bleeding
- Change in consistency or calibre of stools
- General abdominal discomfort (bloating, fullness, cramps or gas)
- A feeling that the bowel does not completely empty after emptying the bowels
- Constant fatigue
- Severe appetite or weight loss
Do note that the symptoms above can be caused by a number of reasons and may not necessary indicate the presence of cancer. However, do make an appointment with your doctor if you have any signs or symptoms that worry you.
Causes and Risk Factors
Colorectal cancer arises from genetic mutations in colon or rectal cells, leading to uncontrolled growth and tumor formation. Although the precise cause of these mutations remains unclear, age, inherited conditions, diet, and lifestyle are known contributing factors.
Factors that can increase the risk of colorectal cancer include:
- Older age
- History of colorectal polyps or cancer
- Inflammatory bowel diseases
- Family history
- Diabetes
- A low-fibre, high fat diet
- A sedentary lifestyle
- Smoking
- Heavy use of alcohol
How to prevent Colorectal Cancer?
- Screening for colorectal cancer is your best protection
- Eat less fat and red meat
- Eat more vegetables, fruit and fibre
- Exercise regularly
- Quit smoking
- Cut down on alcohol consumption, especially distilled spirits
- Control diabetes
What is a Colonoscopy
A colonoscopy is a special test using a flexible tube to look at the internal lining of the colon and rectum. It is the gold standard for complete large bowel evaluation. It has high sensitivity and specificity and the long recommended screening interval of 10 years. During a colonoscopy, asymptomatic polyps can also be removed before they become malignant.
After a thorough bowel cleanse, the colonoscope is inserted through the anus to the part of the colon where the small intestine enters. The doctor will look out for polyps and remove them during the colonoscopy. Colonoscopy is a very safe procedure and the entire procedure usually takes less than 15 minutes and there will be little pain. Mild sedation is given when necessary to relieve anxiety and discomfort. Most patients can resume their regular diet later in the day.
Preparation for a Colonoscopy
A complete bowel preparation is essential for an accurate colonoscopy. This involves fully emptying the colon, typically through an enema or liquid laxative, as prescribed by your doctor. Inadequate preparation may result in a repeat or reschedule of the procedure. It is highly recommended that you please follow your doctor’s instructions carefully.
