When Is the Right Time to Start Colorectal Cancer Screening?

When Should Colorectal Cancer Screening Begin?

For people at average risk, routine colorectal cancer screening generally begins at age 50 in Singapore. Screening is recommended even if you feel well and do not have symptoms, as early colorectal cancer and precancerous polyps may not cause noticeable changes.

The appropriate screening method may depend on your age, risk factors, medical history and previous screening results. Common approaches include:

• Faecal Immunochemical Test (FIT): A stool-based test that checks for small amounts of blood that may not be visible. For average-risk individuals, FIT is commonly performed regularly as a screening test.
• Colonoscopy: A procedure that examines the entire colon and rectum and allows suitable polyps to be removed during the same procedure. It may be recommended based on your risk or following an abnormal screening result.

Other tests may be considered in certain circumstances. Your doctor can advise which screening approach and interval are appropriate for you.

Importantly, the recommended screening age applies to people who do not have symptoms. If you develop symptoms such as blood in the stool, persistent changes in bowel habits, unexplained weight loss or ongoing abdominal discomfort, medical assessment may be needed regardless of your age.

Who May Need to Start Colorectal Cancer Screening Earlier?

While age 50 is a general starting point for people at average risk, not everyone should wait until then. Some people have a higher risk of developing colorectal cancer and may be advised to begin screening earlier or undergo screening more frequently.

Factors that may affect when screening begins include:

There is therefore no single starting age that applies to everyone. If you have a personal or family history that may increase your risk, discussing it with your doctor can help determine when screening should begin and how often it may be needed.

What Happens Once You Are Due for Colorectal Cancer Screening?

Being due for colorectal cancer screening does not necessarily mean you need a colonoscopy immediately. The next step depends on your individual risk and the screening method considered appropriate for you.

For people at average risk, screening may begin with a non-invasive test such as FIT. If the result is positive, a colonoscopy is generally recommended to investigate the source of the detected blood and examine the colon and rectum more closely.

A colonoscopy may also be recommended as the initial screening method for some people, particularly when their medical or family history places them at higher risk. During the procedure, the doctor can examine the lining of the colon and rectum, take tissue samples if necessary and remove suitable polyps for further assessment.

Screening is also not a one-time decision. Depending on the test used and what is found, you may be advised to repeat screening at a recommended interval or undergo further surveillance.

If you are approaching the recommended screening age or are unsure whether your risk factors mean you should start earlier, speak to your doctor about when to begin. The appropriate timing and screening method can then be determined based on your individual risk and medical history.

Plan Your Colorectal Cancer Screening With Dr Kam Ming Hian

Knowing when to start colorectal cancer screening can help you plan ahead rather than wait for symptoms to appear. If you are approaching the recommended screening age or have factors that may increase your risk, a consultation can help determine when and how you should be screened.

At Kam Colorectal Centre, our team provides colorectal screening and assessment based on each patient's individual needs, including colonoscopy when clinically appropriate. Our colorectal care is led by Dr Kam Ming Hian, a senior consultant colorectal surgeon who performs colonoscopy as part of colorectal screening and assessment. To discuss when you should begin colorectal cancer screening or whether a colonoscopy may be appropriate, arrange a consultation.

Frequently Asked Questions (FAQs) About Colorectal Cancer Screening

Meet Our Colorectal Specialist in Singapore

Dr Kam Ming Hian

Senior Consultant Colorectal Surgeon

MBBS (Singapore), M.Med (Surgery), FRCSEd, FAMS

Dr Kam Ming Hian is a Senior Consultant Colorectal Surgeon with more than two decades of clinical experience in the diagnosis and management of colorectal conditions, including colorectal cancer, polyps, haemorrhoids and other disorders affecting the colon and rectum. His practice focuses on providing thorough evaluation, evidence-based treatment and personalised care tailored to each patient's needs.

Dr Kam previously served as Director of Robotics and Minimally Invasive Surgery in the Department of Colorectal Surgery at Singapore General Hospital. He has a strong interest in minimally invasive colorectal procedures, including laparoscopic and robotic-assisted surgery, which aim to support safe and efficient recovery for patients.

In addition to performing colorectal surgery, Dr Kam has carried out thousands of endoscopic procedures such as colonoscopy and gastroscopy, supporting early detection and management of colorectal conditions.