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National Colorectal Cancer Screening Programme

Colorectal cancer is the number one cancer among men and the second most common cancer among women in Singapore. When detected early, colorectal cancer is one of the most preventable and treatable cancers.

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Colorectal cancer is cancer of the colon (the main part of the large intestine) and the rectum (the passageway connecting the colon to the anus). In most people, colorectal cancer develops slowly over several years.

Before cancer forms, a growth of tissue or a tumour usually begins as a non-cancerouspolyp on the inner lining of the colon or rectum. A polyp is a benign growth, and some may develop into cancer over time.

As colorectal cancer normally develops over time, you can prevent the risk of cancer development through regular screening. The best time to screen is when you still feel fine!

You have a higher risk of developing colorectal cancer if you:
Are over 50 years of age
Have a family history of colon or rectum cancer
Have a previous history of colon polyps
Have a history of ulcerative colitis (ulcers in the lining of the large intestine) or Crohn’s disease
Smoke or have a diethigh in fats and low in fruits and vegetables
In the early stages, people with colorectal cancer may not experience any symptoms at all.

In the later stages, common symptoms include:
Changes in bowel habits, including diarrhoea or constipation
Presence of blood in stools
Persistent abdominal discomfort such as cramps, gas or pain
Colorectal surgery
Removing part of the colon that contains the cancer cells.
Chemotherapy
Destroying cancer cells after surgery to control tumour growth or to relieve symptoms of colorectal cancer.
Radiation therapy
Using X-rays to kill any cancer cells that might remain after surgery, shrink large tumours before an operation so that they can be removed more easily, or relieve symptoms of colorectal cancer. Side effects of radiation therapy may include:

  • Diarrhoea
  • Rectal bleeding
  • Fatigue

These options may be used alone or in a combination.
A really simple way to find out if you may have colorectal cancer is through a stool test called FIT. This test can detect small amounts of blood in your stool which are usually invisible to the naked eye.
If you are above 50 years old and do not have any symptoms of colorectal cancer, it is recommended that you do a FIT once a year. This test can be done easily, in the comfort of your home.
How do you use a FIT kit?
Each FIT kit comes with a stick that you can use to scrape up a small amount of stool. Collect two stool samples, each from a fresh bowel movement, over two days for a more accurate result. Simply send in the samples for testing by post within 24 hours using the pre-paid envelope that was provided to you.
The test can be done in five steps.
Step 1:
Write your name, identification number and the sample collection date on the label.
Step 2:
Open the FIT kit. (a) Twist the cap to the left. (b) Pull out the cap with the stick from the kit.
Step 3:
Hold the stick straight down. Scrape up and down two to three times and left to right two to three times across the stool surface.
Step 4:
Collect only a small amount of stool.
Step 5:
Insert the stick into the FIT kit. Twist the cap to close tightly. Shake the FIT kit two to three times.
  • Collect two separate stool samples, each from a fresh bowel movement
  • Use a new FIT kit to collect the second stool sample on a different day
  • Mail the completed FIT kits within 24 hours of each stool collection
  • Store it in a cool and dry place if you are unable to mail the completed FIT kit within the day of the test
  • Add water to the FIT kit
  • Pour out the water from the FIT kit
  • Let water or urine come into contact with the stool sample
  • Collect a stool sample if you have diarrhoea, menstruation, or any bleeding conditions such as haemorrhoids (piles)
Are you eligible for subsidies?
With the enhanced Screen for Life subsidies, the fee is fixed at $5 for eligible Singaporeans, and $2 for eligible Community Health Assist Scheme (CHAS Orange or Blue) and Merdeka Generation (MG) cardholders. Pioneer Generation (PG) cardholders can screen at no cost.
This fee covers the cost of the screening test, the doctor’s consultation for the visit, and the first follow-up consultation, if required.
Pioneer Generation
(PG)
$0
Merdeka Generation (MG)
$2
Community Health Assist Scheme (CHAS) Card Blue or Orange
$2
Community Health Assist Scheme (CHAS) Card Green / Eligible Singapore Citizens
$5
If you are 50 years old and above, you should do a FIT once every year. Check your screening eligibility through HealthHub by logging in with your SingPass.
Where can you get a FIT kit?
You can collect the FIT kit from any CHAS General Practitioner (GP) clinics to do the two-day FIT sampling test at home. Do make an appointment at your preferred CHAS GP clinic before collecting the FIT kit. On the appointment date, please present the relevant documents, your NRIC, and CHAS/MG/PG/PA* card, on your appointment date to qualify for the subsidy.
See your doctor immediately if you develop any colorectal cancer signs or symptoms even after a normal FIT result.
*Eligible Public Assistance (PA) cardholders will receive the same subsidies as PG cardholders.
Colonoscopy is the gold standard for complete large bowel evaluation. It has high sensitivity and specificity and the long recommended screening interval of 10 years. The main disadvantages are its higher costs, the need for full bowel preparation and sedation. There is also a small risk of bowel perforation.
During colonoscopy, asymptomatic polyps can also be removed before they become malignant. For high-risk individuals, this is the screening to go for.
How is colonoscopy done?
Colonoscopy is a procedure that uses a flexible tube (colonoscope) to look at the inner lining of the large intestine (colon and rectum). It takes about 20-30 minutes and has to be done by a doctor trained in doing colonoscopies, in a hospital setting.
How frequently do you need to screen for colorectal cancer?
It depends on your risk level based on your medical condition and family history. You can check your risk level in the table below.
Click  herehere  to view
See your doctor immediately if you develop any colorectal cancer signs or symptoms even after a normal FIT result.
Click  herehere  to view
See your doctor immediately if you develop any colorectal cancer signs or symptoms even after a normal FIT result.
Click  herehere  to view
See your doctor immediately if you develop any colorectal cancer signs or symptoms even after a normal FIT result.
Download our pamphlet about
Colorectal Cancer Screening:
Download our booklet about the
Screen for Life programme:
Get more information on colorectal cancer here:
More information about FIT
More information about Colorectal Cancer
More information about Colonoscopy
Colonoscopy Video
Frequently Asked Questions
Partners


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National Colorectal Cancer Screening Programme
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