Colorectal cancer is the most common cancer in Singapore with both men and women at equal risk. Most colorectal cancers are found in people aged 50 and above. People with a personal or family history of colorectal cancer or polyps, or those with inflammatory bowel disease, are more likely to develop this cancer. Low fibre intake, a high fat diet, smoking, a sedentary lifestyle, and obesity are linked to a higher risk of having colorectal cancer.


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Screening can prevent can­cer through the detection and removal of pre-cancerous growths such as polyps as well as detect cancer at an early stage, when treatment is more successful. As a result, screening reduces colorectal can­cer deaths by both decreasing the number of new colorectal cancer cases and by increasing the likelihood of survival. It is recommended that everyone aged 50 and above who at average risk of getting colorectal cancer undergo one of the screening tests below:


TestBenefitsLimitationsTest Time Interval

Faecal immunochemical test (FIT)

Detects microscopic blood in stool, a common sign of colorectal polyps and cancers

  • Non-invasive
  • No bowel preparation
  • No dietary/drug restriction
  • Sampling collected at home
  • Cheap
  • Widely available
  • Will miss most polyps
  • Requires multiple stool samples
  • Can produce false-positive test results
  • Requires colonoscopy if abnormal


Evaluates the inner lining of entire colon and rectum.

  • Looks at the entire colon
  • Can biopsy and remove polyps
  • Can diagnose other diseases
  • Required for abnormal results from all other tests
  • Full bowel preparation needed
  • Sedation is usually needed
  • Costs more than other forms of testing
  • May miss one day of work
  • Small risk of bleeding, bowel tears or infections during the process
10 years

Flexible Sigmoidoscopy

Examines the inner lining of lower colon and rectum

  • Fairly quick
  • Usually doesn’t require full bowel preparation
  • Sedation usually not used
  • Only examines the last one-third of the colon
  • Can’t remove all polyps;
  • Very small risk of bleeding, bowel tear or infection
  • Colonoscopy will be needed if abnormal
5 years

The recommended screening test depends on your individual risk factors. Please discuss colorectal cancer screening with your doctor if you are in one of the risk groups highlighted in the table below.


RiskPatient DescriptionRecommended Screening Test
  • Aged 50 and above
  • Male or Female
  • No symptoms
  • No family history
  • Faecal Immunochemical Test (FIT)


  • Colonoscopy


  • Flexible Sigmoidoscopy

Any adult, regardless of age, with a:

  • Personal history of colorectal cancer or colon polyps
  • Family member with colorectal cancer or colon polyps
  • Personal history of inflammatory bowel disease (Crohn’s disease or ulcerative colitis)



Dr Chee Cheng Ean

SCS CCAM 2016 Chairperson

Consultant, Department of Haematology-Oncology

National University Cancer Institute, Singapore (NCIS)

Category: Blog