Colonoscopy Screening Singapore

Colorectal Cancer Screening

Colorectal cancer is a significant health concern in Singapore, being the second most common cancer among both men and women. According to the latest Singapore Cancer Registry Annual Report 2021 published by the National Registry of Diseases Office, Health Promotion Board in August 2023, colorectal cancer accounted for 16.3% of all cancers in males and 12.9% in females from 2017 to 2021. It is also a leading cause of cancer deaths, responsible for 14.4% in males and 15.6% in females. Early detection through colonoscopy screening is crucial as it can identify precancerous polyps and early-stage cancers, significantly improving treatment outcomes and survival rates. Regular screening is recommended for adults aged 50 and above.

What is Colonoscopy?

A colonoscopy is a minimally invasive procedure performed by an accredited specialist to examine the inner lining of the large intestine (colon and rectum) for abnormalities. These include asymptomatic polyps, life-threatening cancers, diverticulosis (abnormal outpouchings or “pockets”), and inflammatory bowel diseases causing abdominal pain, rectal bleeding, unexplained weight loss, and changes in bowel movement.

As a diagnostic tool, it can extract tissue samples for biopsies and remove polyps, which may become cancerous. Colonoscopies are done alongside other screening exams for accurate diagnosis. Those with a family or medical history of colorectal conditions should undergo the procedure earlier and more frequently.

During the procedure, a colonoscope—a long, flexible tube with a camera at the end—is inserted through the anus into the rectum, allowing the doctor to view the entire colon. This is typically a day procedure that takes about 30-60 minutes under mild to moderate sedation for comfort.

Why is Colonoscopy Screening Important?

Colonoscopy screening is crucial in Singapore, where colorectal cancer is prevalent. Early detection through colonoscopy increases the likelihood of successful treatment and improves early survival. Most colorectal cancers develop from adenomatous polyps; although many are benign, they grow larger and can turn malignant if left over time. Colonoscopy screening enables the detection and removal of these polyps before they turn cancerous, preventing the development of colorectal cancer.

Colonoscopy screening also aids in diagnosing common but recurring symptoms like abdominal pain, changes in bowel habits, and gastrointestinal bleeding. For high-risk individuals, such as those with a family history of colorectal conditions, regular colonoscopies are vital for early detection and prevention. Furthermore, for patients with a history of colorectal issues, regular screenings are essential for ongoing monitoring and management.

Who Should Go For Colonoscopy Screening in Singapore?

Colonoscopy screenings are recommended for adults aged 50 and above to detect colorectal cancer early. For higher-risk groups, such as those with a family history of colorectal cancer, screenings should start 10 years earlier than the age at which the family member was diagnosed with cancer and may need to be more frequent.

Official indications for diagnostic colonoscopy with a possible need for concurrent gastroscopy include:

Fresh red rectal bleeding (haematochezia)
Unexplained weight loss
Constipation for more than 2 weeks with no colonoscopy in the last 3 years
Tenesmus (sensation of incomplete bowel movement)
Mucus in the stools
Rectal prolapse
Changes in bowel habits lasting more than two weeks
Abdominal bloating or pain for more than 2 weeks
Positive Faecal Occult Blood Test (FOBT)
Positive Faecal Immunochemical Test (FIT)
Iron deficiency anaemia
Elevated serum tumour markers: carcinoembryonic antigen (CEA), CA19-9, CA125
Positive circulating tumour DNA test
Palpable abdominal or rectal mass on examination
Hereditary Nonpolyposis Colorectal Cancer Syndrome
Familial Adenomatous Polyposis syndrome
Megacolon
Inflammatory bowel disease
Suspected colonic pathology on imaging require diagnostic evaluation through colonoscopy and possibly concurrent gastroscopy.

These conditions require diagnostic evaluation through colonoscopy and possibly concurrent gastroscopy.

What To Expect During A Colonoscopy

Pre-Procedure

Fasting & Bowel Preparation: Follow instructions provided for fasting and bowel preparation to ensure a clear view during the colonoscopy.
Arrival: Check into the Endoscopy Centre at least 30 minutes before the procedure.

During The Procedure

Duration: The procedure typically lasts about 15 to 30 minutes.
Sedation: An injection of sedatives will be administered to ensure comfort.
Polyp Removal: Small to moderately large polyps found will be removed immediately. Cancerous lesions will be biopsied.

Post-Procedure

Recovery: You will wake up within 15 to 30 minutes after the procedure.
Discharge: Patients will be discharged from the Endoscopy Centre shortly after. Avoid driving or operating machinery for the rest of the day. Ensure you have a caretaker to bring you home.
Results: The surgeon will explain the results on the same day or at the next scheduled appointment.

Preparing for Colonoscopy Screening

Proper preparation is crucial for a successful colonoscopy screening. Here are key points to note:

Bowel Preparation: Follow the bowel preparation instructions meticulously to empty your colon. Any residue can obstruct the view during the procedure.
Fasting: Fast for at least 6 hours before the colonoscopy. Clear fluids can be consumed up to 2 hours prior.
Health Conditions: If you have kidney, heart, or liver problems, consult your doctor before beginning bowel preparation. Monitor for any abnormal symptoms and seek immediate medical advice if necessary.
Medications: Inform your specialist about any allergies and medications you are taking. You may need to adjust or stop certain medications before the procedure for safety.

Why Colonoscopy with Spectrum Surgery

FAQs on Colonoscopy in Singapore

Polyps are abnormal growths on the internal lining of the colon or rectum. If found, they will be removed during the colonoscopy procedure to prevent them from potentially developing into cancer.

The sedative effects usually diminish within an hour after the procedure. It's important not to drive, work, or make significant decisions for the rest of the day. You might experience gas or bloating, which can be alleviated by walking. Persistent bleeding, pain, or fever should be reported to your doctor immediately.

Bowel preparation has become much more manageable with newer medications. Clear liquids can be consumed up to 2-6 hours before the procedure, but avoid red or orange liquids to prevent confusion during the examination.

Certain medications, particularly blood thinners, can increase the risk of bleeding during the procedure. Informing your doctor about all medications and allergies ensures safety and proper adjustments.

Colonoscopy is a highly effective screening method for colorectal cancer. It is generally recommended every 3 to 10 years, with most individuals needing 2 to 3 screenings in their lifetime.

The procedure is performed under sedation or general anesthesia, so there is no pain. Some patients may feel minor bloating afterward, which typically resolves after passing gas.

Symptoms can include blood in the stool, changes in bowel habits, weight loss, abdominal discomfort, and fatigue. However, early-stage colorectal cancer often has no symptoms.

In most cases, you can continue essential medications, but some may need to be adjusted. Your specialist will provide specific guidance on your medication regimen.

Yes, sedation or anesthesia is used to ensure comfort and relaxation. The options will be discussed with you before the procedure to ensure your safety and comfort during the colonoscopy screening.

Colonoscopy Screening Singapore

Colorectal Cancer Screening

What is Colonoscopy?

Why is Colonoscopy Screening Important?

Who Should Go For Colonoscopy Screening in Singapore?