For average-risk individuals, screening for colorectal cancer should begin at age 50 years. FIT is one of the recommended screening tests and should be performed annually. Average-risk individuals refer to asymptomatic individuals and individuals who do not have a family history of colorectal cancer, as well as those with family history confined to non-first degree relatives or relatives older than 60 years old.

You can undergo colorectal cancer screening (using FIT) through HPB's Screen for Life programme. You will be given two FIT kits because two stool samples should be collected over two days for a more accurate result.

Screening using FIT should be done once a year. However, if you develop any colorectal cancer signs or symptoms even after a normal FIT result, please see your doctor immediately.

For individuals at increased risk or high risk, screening by colonoscopy is also indicated. Please refer to the table below

Risk Group	Onset (Age)	Frequency of colonoscopy screening
i) Average Risk
1. Asymptomatic or family history limited to non-first degree relatives	50 years	Every 5 to 10 years
ii) Increased Risk
1. Colorectal cancer in first degree relative (parent, sibling) age 60 yrs or younger or two or more first degree relatives	10 yrs prior to youngest case in the family or age 40 yrs, whichever is earlier	Every 5 years
2. Colorectal cancer in first degree relative over the age of 60 yrs	50 years	Every 5 to 10 years
3. Personal history of colorectal polyps	1 to 3 yrs after polypectomy in the presence of high risk features (>1cm, multiple, villous architecture); otherwise, 3 to 5 yrs after polypectomy for low risk polyps	-
4. Personal history of colorectal malignancy	One year after resection	Every 1 to 3 years
5. Personal history of ovarian or endometrial cancer	After resection	-
iii) High Risk
1. Family history of familial adenomatous polyposis^	10 to 12 years (from puberty)	Annually*
2. Family history of hereditary non-polyposis colorectal cancer (Lynch Syndrome )^	20 to 25 yrs	Every 1 to 2 years
3. Inflammatory Bowel Disease
a. Left-sided colitis	From 15th yr of diagnosis	Every 1 to 2 years
b. Pan-colitis	From 8th yr of diagnosis	Every 1 to 2 years

The screening colonoscopy:

• Uses a flexible tube (colonoscope) to look at the inner lining of the large intestine (colon and rectum)
• Takes about 20 to 30 minutes to complete
• Has to be done in a hospital by a doctor trained in conducting colonoscopies

The three main treatment options for colorectal cancer are surgery, chemotherapy and radiation. These options may be used alone or in a combination.

• Colorectal surgery: this involves removal of the part of the colon that contains the cancer cells.
• Chemotherapy: chemotherapy can be used to destroy cancer cells after surgery, to control tumour growth or to relieve symptoms of colorectal cancer.
• Radiation therapy: radiation therapy uses X-rays to kill any cancer cells that might remain after surgery, to shrink large tumours before an operation so that they can be removed more easily, or to relieve symptoms of colorectal cancer. Side effects of radiation therapy may include:  
• Diarrhoea
• Rectal bleeding
• Fatigue

A healthy lifestyle can help prevent colorectal cancer and many other diseases. Take steps to reduce your risk of colorectal cancer by: 

• Eating plenty of fruits, vegetables and whole grains which contain fibre and antioxidants
• Limiting fat especially saturated fat from animal sources such as red meat, milk, cheese and ice cream (plant-based "vegetable oil" can also be high in saturated fat)
• Limiting alcohol intake
• Quitting smoking
• Staying physically active and maintaining a healthy body weight