A new Singaporean study has revealed that immediate family members of patients with colorectal cancer are unaware of their increased risk of developing this disease. They were also unaware of the need for screening in their cases, and the importance of colonoscopy as opposed to fecal occult blood tests.

The immediate family members referred to in this case include parents, siblings as well as children of the patients with colorectal cancer.

Results of the study

“Our findings showed that 100 per cent of the first-degree relatives and patients had not undergone colonoscopy and were not aware that it is an accurate test for colorectal cancer,” remarked Dr Tan Ker Kan, a consultant at the National University Cancer Institute (NCIS) in the division of surgical oncology (colorectal surgery) and the lead author for this study.

Dr Tan also expressed that the family members “tend to mix up the basic screening packages and assume that such packages include screening for the risk of colorectal cancer.”

He further discussed the significance of both the fecal occult blood test and colonoscopies. “If these (tiny amounts of blood in the stool) are found – a colonoscopy will be done to determine the cause of the occult blood. Cancer is found only about 5 to 10 per cent of the time,” stated Dr Tan.

Results from the study also pointed to the lack of counseling by doctors during consultations regarding this matter. Immediate family members who are at a higher risk of developing this cancer were not counseled on their risk, and the need for a stricter screening schedule.

The study also denotes that these relatives also are potentially hindered from the relevant screening procedures required because of the fear of the procedure – as well as the perception that it is expensive and the inconvenience of it all. The relatives also thought that because they were still young and asymptomatic that they could defer their screening.

The importance of screening

Dr Tan noted that this study, which was drawn on a sample of 50 colorectal patients and 31 of their first degree relatives, was an inaugural one that had been conducted in Asia – where the barriers of screening amongst first-degree relatives were evaluated.

He also recommended that the immediate family members of patients with colorectal cancer should go for a colonoscopy screening at 10 years prior to the cancer involving the youngest patient in the family or at the age of 50 years.

The National University Hospital offers colonoscopies for SGD$ 300 to SGD$ 615, while the screening cost at the Singapore General Hospital ranges from about SGD$ 580 to SGD$ 830 (for patients eligible for subsidies). Otherwise, it will cost about SGD$ 1,100 to SGD$ 2,500 at public hospitals (excluding subsidies).

Data indicates that colorectal cancer is the most common cancer for men and second most common cancer for women in Singapore. 5 people are diagnosed with this cancer with two fatalities from it daily.

In Singapore, the 5-year survival rate for patients with colorectal cancer ranges between 9.2% in patients (with Stage IV cancer) to 84.3% in patients (with Stage I colorectal cancer). According to other related studies, 10% of first-degree relatives eventually develop colorectal cancer if they are not screened. MIMS

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