Getting screened for colorectal cancer is crucial because this slow-developing disease is often highly treatable when detected early. While colonoscopy is the gold standard for detecting colorectal cancer and precancerous polyps, some individuals have understandable concerns about it. These can include underlying health conditions, the cost of the procedure, potential uncomfortable side effects, and the necessary bowel preparation and sedation.
Fortunately, advances in cancer screening have introduced several alternative tests to colonoscopy in Singapore. These tests can deliver valuable diagnostic information without the invasiveness of traditional colonoscopy.
Stool-based screening options provide a non-invasive approach to detect specific markers that may indicate the presence of cancer or precancerous development. These tests include:
cancer symptom or large polyps. This test comes with an at-home kit that includes a brush
or sampling probe to collect a stool sample, which is then sent to a laboratory for
analysis. Unlike other screening methods, this test does not require dietary restrictions
or laxatives for preparation.
FIT is typically done annually for effective cancer screening. If microscopic blood is
detected in the sample, individuals should see a doctor for further evaluation.
A stool DNA test combines FIT with a specific test that detects DNA mutations in stool.
This test can identify abnormal DNA changes, from cancerous or precancerous cells, shed
into the stool. For this test, a stool sample is collected using a take-home kit provided
by a doctor, which is then sent to a specialised laboratory for blood markers and DNA
mutation analysis.
Compared to FIT, stool DNA testing is more comprehensive and sensitive. Testing is
typically recommended every three years.
Imaging-based alternatives provide a detailed view of the colon lining without requiring any invasive procedures. Common imaging tests include:
CT colonography, also called virtual colonoscopy, uses CT scans and advanced computer technology to create cross-sectional images of the colon and rectum. During the procedure, the doctor inserts a small, flexible tube into the rectum. Air is then pumped into the colon to expand it and detect polyps or abnormalities. The resulting images are displayed on a monitor screen for further assessment. Unlike a traditional colonoscopy procedure, CT colonography is less invasive and does not require sedation.
Barium enema is a specialised X-ray procedure for the colon. This involves introducing a barium-based liquid contrast into the colon through a tube inserted into the rectum. The barium solution then coats the colon walls to produce a clear outline that can be captured on X-ray. In some cases, air may be pumped into the distended colon to improve the clarity and detail of the resulting X-ray images. While less commonly used today, a barium enema test can help identify abnormalities such as polyps or tumours. However, this test is generally less detailed than a colonoscopy.
It is important to note that the aforementioned colonoscopy alternatives may not allow complete or direct visualisation of the colon, facilitate the removal of polyps, or collect tissue samples from abnormal findings. Moreover, imaging tests may require exposure to low doses of radiation, which is particularly undesirable for young individuals and women of reproductive age. Thus, colonoscopy remains the definitive method of colon screening.
Doctors can provide recommendations on which alternative screening method might be suitable for a patient based on the following factors:
Each alternative screening method offers its own set of advantages. Stool-based tests like FIT and FOBT are non-invasive, require no special preparation, and can be done at home. On the other hand, imaging alternatives like CT colonography offer a detailed view of the colon and are less invasive than traditional colonoscopies.
While less invasive, each method comes with potential drawbacks. Stool-based tests may produce false positives or negatives, leading to missed diagnoses. Imaging methods, though less invasive, might still require a follow-up colonoscopy if abnormalities are detected. Additionally, CT colonography involves exposure to a small amount of radiation.
The cost and availability of each method can vary significantly. Stool-based tests are generally more affordable and widely available. Imaging tests, depending on the facility and technology used, may be more expensive. It is also advisable to consider insurance coverage when choosing a method.
The recommended frequency for each screening method varies. Stool-based tests like FIT and FOBT are typically recommended annually, while the stool DNA test can be done every three years. CT colonography is usually recommended every five years. These guidelines help ensure timely detection and intervention if necessary.
Some individuals may prioritise convenience and choose a stool-based test, while others may prefer the more comprehensive nature of a CT colonography. Discussing options with a doctor can help tailor the choice to individual needs and comfort levels.
How often an individual should undergo colon screenings depends on various factors, such as the
type of test used and the personal health risk profile.
In general, colon cancer screening in Singapore should begin at age 50, particularly for
individuals at average risk. However, those with a family history of colorectal cancer or genetic
predispositions may need to start earlier or undergo more regular screenings.
Regular screening is a crucial step in maintaining colorectal health, regardless of which method
you choose—whether it is a stool-based test, virtual colonoscopy, or traditional colonoscopy.
Discussing these options with your doctor is key as they can provide personalised recommendations
tailored to your health history and risk factors.
At Kam Colorectal Centre, we offer a range of services tailored to meet every patient’s needs.
Whether considering a traditional colonoscopy or exploring alternative methods, our
colorectal
specialist
, Dr Kam, has more than two decades of experience diagnosing and managing colorectal
conditions. Contact us today at 6443 1005 to schedule an appointment.
20 Years of Colorectal Experience
Skilled in Minimally Invasive & Laparoscopic Techniques
Individualised & Cost Effective Treatment for Every Patient
Medisave and Insurance-Covered Treatment and Procedures
We are proud to provide patients with highly personalised and affordable colorectal treatments in Singapore. At Kam Colorectal Centre, we’ve got your colorectal health covered.
Call +65 6443 1005 or fill in the form below to book a detailed consultation with us.