Keep Colorectal Cancer at Bay

Learn how to reduce your risk of colorectal cancer by changing your lifestyle now.

Colorectal cancer, also known as colon or bowel cancer, is the most common cancer in Singapore among men, and the second most common cancer in women after breast cancer. Both men and women are equally at risk of colon cancer, but men are more likely to develop rectal cancer.

Colon cancer may also be hereditary. The two most commonly inherited syndromes are hereditary nonpolyposis colorectal cancer (HNPCC) and familial adenomatous polyposis (FAP). Carriers of such genes usually develop colon cancer at a younger age. Women with HNPCC are also at risk of developing other cancers, such as ovarian and uterine cancer. The BRCA-1 gene, which puts carriers at risk for breast and ovarian cancer are also at an increased risk of colorectal cancer.

Singapore has more than 1,200 colon cancer cases every year, and the figure is expected to rise as society becomes more affluent. This is because some of the factors that make people more susceptible to colorectal cancer are usually seen in developed economies: rich food, red meat, processed food, sedentary lifestyles, low-fibre diets, obesity and smoking.

How do you screen for colorectal cancer?

As the early stages of colorectal cancer have no symptoms, it is recommended that stools should be checked for occult blood once you reach 50 years old. This is done through test kits called the faecal occult blood test and faecal immunochemical test. Both kits test for the presence of blood not visible to the naked eye, which allows cancer to be detected.

Both kits are cheap and safe but are not very sensitive in detecting polyps, abnormal small growths on the inner lining of the large intestine. Most colorectal cancers start off as polyps. If such polyps are detected and removed before they turn cancerous, the cancer can be prevented. This can be done through a colonoscopy, in which a long flexible tube is inserted into the colon. As it is able to detect and remove such polyps, colonoscopy procedures have been shown to reduce colon cancer by 80% to 90%.

By the time cancer symptoms appear, the cancer may already be at an advanced stage. Some symptoms include blood in stools, a change in bowel habits, and recurrent unexplained abdominal pain.

How is colorectal cancer treated?

Surgeons can use keyhole surgery to remove tumours that aren’t too big. This means less post-operative pain, an earlier hospital discharge, an earlier return to normal activities and better cosmetic outcomes.

The survival rate for patients with Stage IV colorectal cancer has increased over the past two decades. For colorectal cancer, the liver and the lung are two of the most common sites where the cancer cells can spread to.

Ways to reduce your colorectal cancer risk:

  • Reduce your intake of red and processed meats.
  • Increase your intake of vegetables and fruits.
  • Have an active lifestyle and exercise regularly.
  • Stop smoking.
  • Maintain a healthy weight.
  • If you’re 50 and above, schedule colonoscopy screening with a specialist.


This article was written by Dr Ho Choon Kiat, Laparoscopic, Hepato-Pancreato-Biliary and General Surgeon at Thomson Surgical Centre.