Do Get Caught With Your Pants Down (Part 1)
What is Colorectal Cancer?
Colorectal cancer affects the colon (the longest part of the large intestine) or the rectum (the passageway connecting the colon to the anus). It is sometimes referred to separately as colon cancer or rectal cancer.
This type of cancer is becoming more common in developed countries around the world, including Singapore. This is partly due to the increased risk factors that come with a more affluent lifestyle, such as obesity, diabetes, and alcohol consumption.
Colorectal Cancer in Singapore
According to HealthHub, colorectal cancer is the most common cancer in Singapore. Our increasing affluence has seen a rise in the associated risk factors above, which helps explain why colorectal cancer is so common here:
Obesity rates are rising. People are on average 3kg heavier than 15 years ago.
59% of people consume more than the recommended daily calorie intake.
Alcohol consumption has tripled, with almost 10% regularly binge drinking.
Smoking among younger people has increased by 33%.
Diabetes is on the rise, currently affecting about 400,000 people.
Source: Why is Colorectal Cancer So Common in Singapore” by Dr Chong Chee Keong, 8 Nov 2018
Risks and Prevention
The exact cause of colorectal cancer is unknown, although there are associated risk factors as noted above:
Age: above 50 years
Ethnicity: if you are Chinese (also African American and Eastern European)
Personal history: of colorectal polyps or previous colorectal cancer
Family history: inherited familial polyps, or relatives with colorectal cancer
Ulcerative colitis: a disease which leads to inflammation of the bowels
Sedentary lifestyle and obesity
Diet: high in red meat, processed foods, and alcohol
While you cannot control factors such as age, ethnicity, and medical history, you can improve your lifestyle and diet.
Physical activity improves the movement of faeces in the colon and thus reduces your risk of colorectal cancer. Eating fruits and vegetables, which are high in dietary fibre, has a similar positive effect. You can also reduce your alcohol intake and cut down on smoking.
Importance of Regular Screening
A simple test to screen for colorectal cancer is the Faecal Immunochemical Test (FIT). This detects small amounts of blood in the stool which cannot be seen with the naked eye. If you are over 50 years old and otherwise healthy, an annual test is recommended.
The FIT screen can be done at any CHAS GP clinic, and costs only SGD 5 for Singapore Citizens with a green CHAS card. Pioneer and Merdeka Generations, and blue or orange CHAS card holders, get further subsidies. You can check your eligibility for subsidised screening using your SingPass.
Colonoscopy – The Gold Standard
Should you test positive or exhibit symptoms of colorectal cancer, a colonoscopy is usually performed. A flexible tube allows your doctor to look at the internal lining of your colon and rectum, and take a biopsy if necessary. This usually takes about 15 minutes, and is performed as an outpatient procedure. It is relatively painless, though a mild sedative can be given to ease any stress or discomfort.
Your MediSave can be used for a colonoscopy, subject to existing withdrawal limits per year. The current limit is SGD 950 for a colonoscopy, and up to SGD 1,550 for a colonoscopy with removal of polyps. You can also claim up to SGD 300 per day for related hospital charges.
Conclusion
Colorectal cancer is highly treatable and often curable if localised and treated early. At stage 1, the cure rate is above 90%. The 5-year survival rates are 40–60% for stage 3, and 10% for stage 4. Early detection is key, and hence regular screening is extremely important.
Check your eligibility for subsidised screening (for Singapore citizens) under HealthHub’s Screen for Life programme, or call the Healthline at 1800-223-1313.
In the next article, we outline the signs and symptoms as well as treatment options for colorectal cancer.
