Screen early for colorectal cancer and prevent it


  • Fitness
  • Saturday, 13 Dec 2014

The Faecal Occult Blood Test is a simple screening test for colorectal cancer that can be done at home, although the results need to be processed in a laboratory. - Filepic

Catching this common cancer early increases the survival rate up to 90%.

Colorectal cancer is one of the most common malignancies in the world.

According to the American Cancer Society, an estimated 136,830 new cases and more than 50,000 deaths from colon and rectal cancer in the United States were predicted in

this year.

The National Cancer Registry’s latest report dubbed colorectal cancer as the most common cancer among men and the third most common among women in Malaysia.

The incidence of the disease increases exponentially with age.

More than 90% of the colorectal cancer cases in Malaysia initially occurs in people over the age of 40, with the chances of the cancer occurring increasing significantly for those above 50.

Therefore, routine colorectal cancer screening should be done in those between the ages of 50 and 75.

However, those with an increased risk due to family history of colorectal cancer should start screening at an even younger age, and/or have more frequent screening tests done.

All about the gut

Colorectal cancer can develop either in the colon (large intestines) or in the rectum, where it is more commonly reported (32% of cases).

Both the colon and rectum are part of the digestive system.

The colon helps to reabsorb fluids and nutrients from waste back into the body and prepare for its elimination, while the rectum functions as a temporary storehouse for our waste (in the form of faeces) prior to defecation.

Furthermore, studies have shown that those who have a medical history of diabetes, low dietary fibre intake, eat an excessive amount of red meat, drink alcohol, smoke cigarettes and lack physical activity, are more likely to develop colorectal cancer.

The most common symptoms, in descending order of occurrence in patients, are diarrhoea, constipation or other changes in bowel habits (e.g. blood in the stool), followed by weight loss and abdominal pain.

Screening options

Note that most colorectal cancers develop from polyps, and their preemptive removal can prevent the onset of colorectal cancer.

Polyps are abnormal growths in the colon lining that are usually benign (non-cancerous).

However, early cancer may have no outward symptoms. Therefore, regular screening is paramount.

Although numerous methods are available, two stand out as the most comprehensive:

l Colonoscopy

It is a health test that allows doctors to probe into your large intestines (colon and rectum) using a device known as a colonoscope – essentially a tiny microscopic camera attached to thin, flexible tubing – for signs of ulcers, colon polyps, tumours and areas of inflammation or bleeding.

Colonoscopy is also used to remove the polyps once they have been positively identified and located.

Similarly, one could opt for the flexible sigmoidoscopy test, which is basically the same as colonoscopy, but with a smaller area of observation – you can only look into the left side of the colon (sigmoid colon), therefore, the test may not be able to determine the condition of your intestines in its entirety.

l Faecal Occult Blood Test (FOBT)

Polyps and colorectal cancers usually bleed. So, as stool moves along the large intestines, it is smeared with the blood.

The test is able to detect traces of blood in the stool, plus, it is low-cost, non-invasive and easy to do.

FOBT is the most commonly-used test worldwide.

In fact, you can get a FOBT do-it-yourself kit (consisting of a test card and swabbing stick) from any government or private hospital or clinic.

This kit allows you to screen for signs of colorectal cancer in the relative comfort of your own home; just remember to send it back for proper laboratory processing.

If results are positive for bleeding, an endoscopy is highly recommended and should be your next course at action.

Stop it early

The survival rate for colorectal cancer can be as high as 90%, if the disease is detected early. This is quite a high survival rate for cancers.

Do keep yourself informed by talking to your healthcare provider about when to begin screening, what test(s) to have, the advantages and disadvantages (including potential harms) of each test, and how often to undergo screening.

A simple change in lifestyle choices, for example, eating healthier foods such as more vegetables and fibre-filled foods, cutting down on red meat, as well as regular exercise, can decrease your chances of colorectal cancer significantly.

Even smoking and excessive alcohol-drinking – although hard to curb – are perfectly controllable through the smart choices we can make for ourselves and the ones we love.


Datuk Dr Muhammad Radzi Abu Hassan is a consultant gastroenterologist and member of the Digestive Health Advisory Board. The author is not associated with, and does not endorse any brands or products. For a free digestive health info guide or more information, please contact 03-5632 3301.

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