Survey: Too few go for regular colorectal cancer screening

By Poon Chian Hui, The Straits Times, 11 Sep 2013

TOO few people are getting screened for colorectal cancer regularly, despite knowing that early detection of the top cancer in Singapore can save lives.

Only a quarter of men and women over 50 are up to date with their screening, according to a national survey led by the National University Hospital (NUH).

One key reason is that most people do not believe that they will succumb to the disease.

This is despite the latest five-year figures from the Singapore Cancer Registry showing that there is an average of 1,746 new cases of colorectal cancer and 715 deaths resulting from it every year. This "big disconnect" is among the worrying trends unearthed in the study of 1,743 people.

Said principal investigator Reuben Wong, a consultant with NUH's gastroenterology and hepatology division: "Clearly, the lack of understanding that they can be susceptible to the disease is worrying."

The study showed that about half also prefer to simply leave things to fate.

"The idea of fatalism is also a mentality that needs to be corrected," noted Dr Wong.

Due to these beliefs, people fail to go for check-ups. But colorectal cancer is a disease that can be prevented easily, he added.

There are two screening methods used routinely here - the faecal occult blood test, which tests for blood in the stool, and the colonoscopy, in which a tube with a video camera is inserted into the anus to spot any abnormalities.

People over 50 are usually advised to go for a colonoscopy once every 10 years. Those with a family history of the disease will be advised to get tested more often.

Some 83.4 per cent of the study's respondents said they were concerned that screening tests are too expensive.

A colonoscopy costs $250 for each subsidised patient, and the faecal occult blood test is only about $10 to $20.

As such, the high cost could be more of a misconception, reported the study.

Men and women also have different motivations to go for testing. For instance, men are more likely to get screened if their doctor recommends it while women respond more strongly if they have relatives with colorectal cancer.

Women are also more motivated by public health talks, but harbour greater fears about the tests.

But doctors also need to do more - only 22.6 per cent have been told by their doctors to get tested.

Housewife Irene Tan, 59, has been going for regular screening for more than 10 years. Her mother died of the cancer in 1997 at the age of 63.

Since then, she has had about 20 polyps, which can lead to cancer, removed.

"Maybe people fear the cost and of getting the result," she said. "But it is worth doing for peace of mind."

Findings at a glance

- Those who are up to date with screening: 27%

- Know that screening can detect colorectal cancer and save lives: 90%

- Don't believe they will get colorectal cancer: 65%

- Feel that such things are fated: about 45%

- Men, women who have been advised by their doctors to be tested: 23%

- Men 3.5 times more likely to get screened if advised by doctor

- Women 2.5 times more likely to test if someone in their family has the disease