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A Message for Our Valued Oncology Patients

We are proud to announce that as of 1 Nov 2017, oncology services, physicians and nurses will transition to Tan Tock Seng Hospital (“TTSH”), a member of the National Healthcare Group.

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Colorectal Cancer Awareness

What You Need to Know

Colorectal cancer, also known as colon cancer, is the most common cancer among Singaporeans 50 and above. In Singapore, it is the No. 1 cancer diagnosis for men and No. 2 for women. Colorectal cancer is also the second most common cause of cancer deaths in men and third most common cause of cancer deaths in women in Singapore.

Cancer occurs when cells of the colon or rectum become abnormal and grow uncontrollably, interfering with the function of these organs and sometimes the surrounding tissue and organs. Since most colorectal cancer cases begin as small, benign growths, known as polyps, on the wall of the colon, both men and women should get regular screenings to drastically reduce and prevent this disease.

Visit the Johns Hopkins Health Library for more information on colorectal cancer.

Common Risk Factors for Colorectal Cancer

The following factors increase your risk for colorectal cancer: 

  • Being over age 50
  • Having a parent, sibling or child with colorectal cancer 
  • Previously having colorectal cancer, large colorectal polyps, ovarian cancer or inflammatory bowel disease
  • Inheriting familial adenomatous polyposis, which results in an overgrowth of colorectal polyps early in life and an 80–100 percent risk of developing colorectal cancer 
  • Having hereditary nonpolyposis colon cancer or Lynch syndrome, a disorder that increases the risk of cancers of the colon, rectum, stomach, small intestine, liver, gallbladder ducts, upper urinary tract, brain and skin
  • Consuming three or more alcoholic drinks per day
  • Eating a diet high in animal fats, specifically red and processed meats 
  • Eating a diet low in fruits, vegetables and fiber
  • Smoking cigarettes
  • Being obese

Preventing Colorectal Cancer

Engaging in the following activities may decrease your risk of colorectal cancer: 

  • Get regular screenings if you are 50–70 years old
  • Maintain a healthy weight throughout life
  • Adopt a physically active lifestyle
  • Limit your alcoholic beverages to two per day
  • Consume a healthy diet with an emphasis on plant sources:
    • Eat five or more servings of various vegetables and fruits each day
    • Choose whole grains and foods high in fiber
    • Limit your consumption of processed and red meats 
    • Consume fresh fish one to three times per week
  • Take an aspirin every day for at least five years 
  • Use combination hormone replacement therapy (postmenopausal women)
  • Remove colorectal polyps or adenomas larger than 1 centimeter

Colorectal Cancer Symptoms 

The following common symptoms may indicate colorectal cancer: 

  • Change in bowel habits or blood in the stool
  • Frequent pelvic pain, bloating, fullness or cramps
  • Weight loss for no known reason
  • Change in appetite
  • Frequently feeling exhausted
  • Distended stomach and pain
  • Anemia
  • Diarrhea that is not the result of gastroenteritis or flu
  • A long period of constipation
  • Persistent decrease in size or caliber of stool
  • Unusual and continuing lack of energy

Colorectal Cancer Screening   

Early detection is key to successfully treating colorectal cancer. However, according to the Singapore Cancer Society, two-thirds of Singaporeans have not been screened for the disease. The Health Promotion Board in Singapore recommends that those ages 50 or above undergo screening. There are multiple screening mechanisms for the disease. Here are some that your physician may utilize: 

  • Barium Enema is used to perform an X-ray of the rectum and colon 
  • Colonoscopy involves a physician inserting a colonoscope through the anus and into the large intestine to check for polyps
  • Digital Rectal Exam involves a physician inserting a gloved, lubricated finger into your rectum to feel for abnormalities
  • Fecal Occult Blood Test looks for blood in the stool
  • Flexible Sigmoidoscopy utilizes a thin, flexible, lighted tube to see the affected area
  • Virtual Colonoscopy uses CT imaging
  • Stool DNA Test is a commercial kit prescribed by a physician to detect abnormal cells shed from large colorectal polyps or cancers

Diagnosing and Staging Colorectal Cancer 

The same investigations that are used for screening are used to confirm a colorectal cancer diagnosis. Tests necessary for diagnosis are:
  • Endoscopy
    • Colonoscopy, sigmoidoscopy
  • Imaging
    • CT chest, abdomen, pelvis 
    • PET/CT in certain circumstances
    • MRI for rectal cancer 
    • MRI of the liver in selected cases
  • Blood tests
    • Tumor markers and other tests

Colorectal Cancer Treatment  

Treatment for colorectal cancer varies and depends on the type of cancer. The Johns Hopkins Singapore team of experts assesses each patient to develop an individualized treatment plan based on the specific characteristics of the cancer and the patient. 

Treatment plans may include a single therapy or combination of therapies including surgery, chemotherapy, biological agents and radiation.

Request an Appointment

Learn more about our physicians, health screening programs and how we treat cancer here at Johns Hopkins Singapore. To request an appointment for a consultation or screening, call the Johns Hopkins Singapore team at +65-6251-1831.

Researchers at Johns Hopkins Singapore and the Johns Hopkins Kimmel Cancer Center in Baltimore, Md., in the United States, have collaborated for more than a decade to better understand cancers common to Southeast Asia. This multidisciplinary collaboration helps us develop more effective, specialized treatments and improve care in ways that best fit local needs.