Thomas Ho SURGERY
Everybody needs a colonoscopy at some point in their adult life! Did you know that Singaporeans have a 5% lifetime risk of developing cancer? This risk increases as we age! As with any cancer, the outcome or prognosis is better when it is detected at an early stage. With regular colonoscopy, we have the ability to survey the colon for early cancers and biopsy them before an actual surgery. Better still, the detection of polyps during colonoscopy enables the problem to be ‘nipped in the bud’ (literally!). This is because colorectal cancers are thought to originate as small polyps that eventually undergo malignant transformation into cancers.
The Health Promotion Board recommends a screening colonoscopy for everyone above the age of 50. Any individual who has a first-degree relative with a history of colon cancer, the recommendation is to do a colonoscopy 10 years prior to that index case.
Beyond the first screening colonoscopy, the frequency is dictated by:
– Presence of symptoms such as bleeding in the stools, change in bowel frequency or consistency.
– Presence of polyps (type, size & number) found in the previous scope.
It’s good to have a discussion with your surgeon about the need for a colonoscopy and how often to repeat it.
Colonoscopy is the best way to detect polyps and cancers. Scans such as CT colonography and barium enema may not be sensitive enough to pick up tiny polyps. Through a scope, a surgeon can both view and biopsy (take a sample) for histology. This is crucial for confirming the diagnosis before an actual resection surgery is recommended.
Other than diagnosis, the colonoscope may sometimes be used to treat rectal cancer when it is at its earliest stage (T1). This is feasible via a highly specialised technique known as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Not every early cancer is suitable for this endoscopic resection though.
It is one of the commonest procedure being performed amongst Singaporeans. This is in part due to an effective public health campaign towards awareness of colorectal cancer. I’m sure that amongst your relatives, friends and colleagues, there will be at least a couple of them who have undergone a colonoscopy. As mentioned earlier, some people do need to have a repeat colonoscopy because of abnormal findings or the emergence of new symptoms.
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