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Lack of physical activity, a diet low in fibre and high in fat, obesity, smoking and drinking alcohol – these are risk factors of colorectal cancer you can address straight away with a healthy lifestyle. Then when you hit age 50 (or earlier if you have a family history), get screened every year.Sounds straightforward enough. But statistics show that, today, this form of the disease is the most common cancer among Singaporean men, with 4,434 new cases diagnosed between 2006 and 2010. It’s second only to lung cancer as a cause of cancer-related deaths among local men, and is very much a product of ignorance rather than recklessness.Lack of awareness“The high incidence (of colorectal cancer) in Singapore reflects the lack of awareness of the screening methods,” says Dr Lim Jit Fong, senior consultant and director at Fortis Surgical Hospital. There are primarily two methods for detecting this cancer: Faecal Immunochemical Test (Fit) and colonoscopy.Three years ago, the Health Promotion Board (HPB) launched the National Colorectal Cancer Screening Programme, encouraging those aged 50 and older to get screened annually for the disease using two-day Fit kits. Regular screening is vital, as more than half the people diagnosed with colorectal cancer have no symptoms, says Dr Zee Ying Kiat, consultant medical oncologist at Parkway Cancer Centre.“Silent” disease“Colorectal cancer is a ‘silent’ disease,” says Dr Shyamala Thilagaratnam, director of the Healthy Aging Division at the HPB. “Even if you feel generally well, you’ll never be sure if you’re really healthy on the inside, unless you go for screening,” she adds.Colonoscopy, in particular, can detect and remove polyps – growths in the colon that might be precursors to colorectal cancer.The family factor People with a strong family history of the disease are at an increased risk of falling for it. “Family members of such patients are advised to undergo screening at least 10 years prior to the onset of cancer in the youngest family member,” says Dr Lim.Monitor your family’s cancer history“For example, if a patient develops colorectal cancer at the age of 50, the immediate family members – including his children – are advised to start screening from the age of 40 or earlier. This is because most colorectal cancers take about 10 years to develop from a normal colonic cell.”Besides this type of cancer, a family history of endometrial, ovarian or breast cancer, colorectal polyps or inflammatory bowel diseases such as Crohn’s disease can also elevate one’s risk of developing it, says Dr Shyamala.New screening toolsMolecular genetics research and newer screening tools are good bets to improve your chances against this disease in the not-too-distant future. Already, there’s a blood test kit (available in Singapore since 2012) that checks for 18 genes associated with cancer. “This helps doctors identify patients with early-stage colorectal cancer who are at high risk of developing cancer recurrence,” says Dr Lim.Minimally invasive surgery techniquesAt the same time, minimally invasive “keyhole” techniques are being introduced in colorectal cancer surgery, which helps reduce patient recovery time and complications. An advance in colonoscopy technology allows doctors to remove larger polyps without the need for surgery.Swop beef for chicken If detected early, the chances of survival from this disease “exceeds 90 per cent”, says Dr Zee. However, prevention – possible in the case of colorectal cancer – is better than cure. If you’re in your 20s or 30s, with annual screening a distant prospect, begin by swopping beef for chicken. “There’s strong and consistent evidence that eating red and processed meat increases the risk,” he stresses.Add fibre to your diet Add to your diet foods such as oats and bran as well. According to Dr Zee: “The evidence for the protective effect of fibre has strengthened in the past few years. Overall, this shows that the intake of dietary fibre – particularly from cereals and wholegrains – reduces the risk of colorectal cancer.”The lesson? Lay the groundwork and you can swing a potentially deadly numbers game in your favour.
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