Dr Tan Chi Chiu
MBBS (S'pore),
MMed (Internal Medicine),
MRCP (Ireland),
MRCP (UK),
FRCP (Edinburgh),
FRCP (London),
FAMS (Gastroenterology)
Gastroenterologist
and Physician
Gastroenterology and Medicine International Pte Ltd
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Summary
Cancer screening for asymptomatic individuals is appropriate for some cancers, including colorectal cancer (cancer of the colon and rectum).
Colorectal cancer is very common in the population. Some estimates suggest that one in eighteen people could suffer from this disease.
There are many means of screening, including faecal occult blood, barium enema x-rays and endoscopy.
Different combinations of these tests can be used, but they all have relative advantages and disadvantages.
Many doctors regard colonoscopy as the most accurate screening test for colorectal cancer, as it views the entire colon, allows biopsy of suspicious lesions and removal of polyps.
Colonoscopy (and endoscopy in general) is very safe when done by experienced doctors. It is also very comfortable for the patient when it is done under gentle sedation.
Screening for people at or over the age of 50 is appropriate. Screening may also be done for people with a family history of colorectal cancer or polyps, or who suffer from inflammatory bowel disease.
Colorectal polyps and early cancer usually have no symptoms. By the time there are symptoms such as change of bowel habit, bleeding or pain, often it is due to a cancer at an advanced stage when the chance for cure is lower.
It is therefore important to screen for colorectal cancer.
* Reproduced with permission from Penny Nield and Brian Gazzard.
Patient Pictures -Gastroenterology. Oxford: Health Press, 1997.
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