Colorectal cancer rates may have levelled off

Hope of fall in cases in coming years as screening appears to have worked
By Salma Khalik, The Straits Times, 19 Apr 2014

THE rate at which people develop colorectal cancer - the most common cancer here - appears to have plateaued.

This suggests that preventive measures here, including screening, may be working and raises hopes that the incidence of colorectal cancer may decline in the coming years.

More than 1,700 people here are diagnosed with colorectal cancer every year and more than 700 die from it. It is among the top three cancer killers here.

The number of people getting such cancer had been rising steadily since 1973 - until a decade ago, said Dr Yong Wei Peng, a senior consultant at the National University Cancer Institute, Singapore.

Between 2003 and 2007, 40.6 men and 29.1 women per 100,000 were diagnosed with colorectal cancer, figures from the Singapore Cancer Registry show.

They dipped to 39.4 men and 27.1 women in the period of 2008 to 2012.

Dr Yong said: "It is too early to conclude if this represents year-to-year fluctuation or true reduction in colorectal cancer incidence."

But he is cautiously optimistic that a smaller proportion of the population will develop this highly preventable cancer in the coming years because screening rates here have been improving.

The number of people here who were screened for colorectal cancer grew from 27 per cent in 2011 to 34 per cent last year, Minister for Health Gan Kim Yong told Parliament this month.

Regular screening, which spots and removes abnormal growths called polyps from the intestines before they turn cancerous, can help reduce cancer rates, Dr Yong said.

In the United States, for instance, the incidence of colorectal cancer has dropped by 3.4 per cent a year in the past decade, pushing the cancer from top spot to third place.

An article in CA, a US cancer journal for doctors, said the fall is largely due to screening.

In 2000, about 19 per cent of Americans aged 50 years and older went for screening tests called colonoscopies. By 2010, 55 per cent did such screening every five to 10 years.

This has led to early discovery of the cancer in 40 per cent of the patients, giving them more than 90 per cent chance of surviving beyond five years.

Dr Francis Chin, a senior consultant in radiation oncology at the National Cancer Centre Singapore, said cancer trends here tend to follow those of the US, but lag by several years.

A possible reason is that the US has good medical practices, which Singapore then adopts later. It then sees similar outcomes of such practices years later.

Screening rates here look set to improve even further.

Mr Gan had said: "We will continue to step up our efforts to raise screening coverage."

From this year, colorectal cancer screening has become part of subsidised health screening for people aged 40 years and older.

Till the end of this month, residents aged 50 years and older can pick up a free colorectal self-screening kit at polyclinics, 73 Guardian outlets, and Singapore Cancer Society offices in Bishan and Realty Centre.

Survival rates from colorectal cancer have also improved significantly here. The Singapore Cancer Registry attributes this to better treatment available today.

In the US, 65 per cent of colorectal cancer patients survive beyond five years, compared with slightly over 50 per cent here.