Colorectal cancer might not be as well-known as other forms of cancer, but did you know that it’s actually the most commonly diagnosed cancer in Singapore?
Every March, to commemorate Colorectal Cancer Awareness Month, my clinic staff and I at G&L Surgical engage in a series of activities. This includes ramping up educational posts on colon cancer screening on Facebook and taking clinic photos.
This year, we decided to try something different and shoot videos on YouTube and TikTok!
As such, I thought I might also share a little on here on;
- The significance of colorectal cancer awareness month
- What colorectal cancer is
- The importance of screening and how to get screened
What is Colorectal Cancer Awareness Month?
Colorectal Cancer Awareness Month1 was designated by former US President Bill Clinton in 2000. Since then, every March has been the month to raise awareness of the disease and honour those affected. This includes wearing blue, the official colour of this global event.
Colorectal Cancer Awareness Month encourages people to go for early screening and promotes healthy lifestyle habits to prevent colon cancer.
How prevalent is colorectal cancer?
Colon cancer is the second leading2 cause of cancer-related deaths globally, and is the third most commonly occurring cancer in men and second most commonly occurring cancer in women.
Read: Why do women with gynaecological cancers have a higher risk of colon cancer?
It’s especially prominent in Asia, and accounts for more than half of all new cases and deaths globally. I’ve especially observed an uptick over the past 30 to 40 years. In fact, countries like Japan, Korea, China and Singapore saw higher case incidences within Asia.
In Singapore3, it is the number one cancer among males and the number two cancer among females.
Colorectal cancer: A very preventable disease with silent symptoms
Colorectal cancer usually starts as a polyp (tissue growths that look like small, flat bumps) and as it grows it becomes a cancer. The initial phase of polyp growth is benign and not a cancer – this is the best time to remove it, as the chances of getting colon cancer is very minimal at this stage.
At the beginning, you might not experience any symptoms at all, but as the cancer progresses, here are some tell-tale symptoms to look out for:
Intermediate stage
- Bleeding when passing your stools
- Abdominal discomfort or bloatedness
- Abdominal pain
- Excessive gas
- Constipation or diarrhoea
- Changes in your stool colour or shape
Advanced stage
- You can feel a mass or lump
- Experiencing unintentional weight loss
- Changes in your stool that last longer than a month
- Excessive fatigue
How do I screen for colon cancer and what is the procedure like?
There are 3 ways I screen for colon cancer – a stool test, colonoscopy and CT colonography. Stool-based tests are recommended for people who have average risk, while visual tests (colonoscopy and CT colonography) are recommended for those at high risk.
Stool test
There are 2 types of stool tests – the Faecal Occult Blood Test (FOBT), which detects blood in the stools and the Faecal Immunochemical Test (FIT), which detects haemoglobin, a protein found in the blood.
For the FOBT, you’ll have to avoid certain foods and medications, such as red meat and nonsteroidal anti-inflammatory drugs (NSAIDs) as they may interfere with test results.
In Singapore, these tests are sent to everybody above the age of 60 to detect possible cases of colon cancer.
Colonoscopy
The other most common tool that is used to detect colon cancer in Singapore is a colonoscopy. How this works is that a long tube is inserted into your rectum with a small camera attached. This allows your doctor to look out for anything unusual or polyps and it’s usually performed after stool tests which might have indicated that you have colon cancer.
To prepare for a colonoscopy, you’ll be required to empty your colon and avoid any solid foods the day before the procedure. You might also be asked to temporarily stop any medications.
Read more on colonoscopy screening in Singapore.
CT Colonography
This is a newer method of screening and helps to provide the doctor with a detailed image of your colon. When this procedure is carried out, it usually means that there is existing evidence of colon cancer or early colon cancers.
Is screening important?
Early detection is key4 for colon cancer, which is very much preventable and can be cured. Furthermore, since colon cancer often has no symptoms during the early stages, it is often caught during routine screenings.
Screening is especially key if you’re in these high-risk groups:
Have symptoms of colon cancer
If you’re experiencing common symptoms like those stated earlier (i.e. bleeding when passing your stools, abdominal discomfort, obvious mass or lump).
Aged 50 and above
If you’re above this age, you have a slightly increased risk of colon cancer. The Ministry Of Health recommends undergoing a screening every 5 years (i.e. at age 50, 55 and 60).
Strong family history of colon cancer
If your 1st or 2nd-degree relatives have had colon cancer (even if you’re not near 50) it’s highly advisable to go for a screening nonetheless
Have a previous history of colon polyps
Can colon cancer be prevented?
While risk factors like family history and age aren’t preventable, lifestyle factors are. In fact, approximately 70%5 of colon cancer cases are influenced by factors like dietary habits, physical activity, smoking and alcohol consumption – and hence can be avoided!
Here are some changes you can take to reduce your risk:
- Opt for a high fibre, low fat diet
- Drink lots of water
- Exercise regularly
- Lose weight, if your doctor recommends it
- Quit smoking
- Reduce alcohol consumption
How do I find out more about colon cancer?
If you’re inspired to go for a screening or simply want to find out more about colorectal cancer, make an appointment and have a chat with me now!
References
- International Agency for Research on Cancer. (n.d.). Colorectal Cancer Awareness Month 2022 – IARC. IARC. Retrieved March 25, 2022, from https://www.iarc.who.int/featured-news/colorectal-cancer-awareness-month-2022/
- World Cancer Research Fund. (n.d.). Colorectal cancer statistics. World Cancer Research Fund. Retrieved March 25, 2022, from https://www.wcrf.org/dietandcancer/colorectal-cancer-statistics/
- HealthHub. (2019, June 14). 9 Must Know Facts About Colorectal Cancer. HealthHub. Retrieved March 25, 2022, from https://www.healthhub.sg/live-healthy/2056/9-Must-Know-Facts-About-Colorectal-Cancer
- Beck, D. E. (2015, Spring). The Importance of Colorectal Cancer Screening. The Ochsner Journal, 15(1), 11-12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365838/
- Wong, M. C., Ding, H., Wang, J., Chan, P. S., & Huang, J. (2019, July). Prevalence and risk factors of colorectal cancer in Asia. Intestinal Research, 17(3), 317–329. 10.5217/ir.2019.00021
Dr Ganesh Ramalingam graduated from the National University of Singapore in 1997 and completed his post graduate training and Fellowship with the Royal College of Surgeons, Edinburgh. He is currently a Consultant General Surgeon with G&L Surgical Clinic, and specialises in General Surgery, Bariatric and Advanced Laparoscopic Surgery, Endoscopy, and Trauma.
