CRC screening

14 April 2014

Question No. 814

Name of Person: Mr Chen Show Mao, MP for Aljunied GRC

Question

To ask the Minister for Health (a) what steps are being taken in implementing a nationwide programme for colonoscopy; (b) how much additional resources are needed in terms of facilities and number of specialists for such a programme; (c) whether there is a timeframe for implementing such a programme; and (d) given that screening participation rates typically take time to build up, whether the Ministry will consider running a pilot programme in the interim.

Answer

1.       Colorectal cancer is the most common cancer in Singapore. Screening for colorectal cancer in the recommended age-groups can detect cancers early, and has been shown to reduce mortality and improve health outcomes. Hence, the National Colorectal Cancer Screening Programme was established in 2011. Outreach for the programme was enhanced when colorectal cancer screening was incorporated into the Integrated Screening Programme (ISP).

2.       Under the ISP, Singaporeans and Permanent Residents aged 50 years and above are invited to screen for colorectal cancer annually using the Faecal Immunochemical Test (FIT) kits at the Community Health Assist Scheme (CHAS) GP clinics. The FIT test is available free of charge and CHAS patients enjoy a subsidy of $18.50 for each related GP consultations up to two visits a year. Under the CHAS scheme, GPs can also make subsidised referrals for those with abnormal results to have further tests done at the public hospitals, such as colonoscopy.

3.       Those who do not wish to go for FIT test may opt for colonoscopy once every 10 years to screen for colorectal cancer. Medisave can be used to pay for colonoscopy. However, the procedure is not without risks as 1 in 10,000 may have perforation of the colon or other complications. 

4.       Based on data from the Health Behavioural Surveillance Survey in 2013, 33.8% of Singaporeans aged 50-69 years old were screened for colorectal cancer with either FIT or colonoscopy within the recommended period. While this is an improvement from screening coverage of 26.8% in 2011, we will continue to step up our efforts to raise screening coverage with either FIT or colonoscopy. We will ensure that there are sufficient specialists and facilities available to perform colonoscopy for those with abnormal FIT results.

5.       Under the ISP, we will continue to encourage eligible Singaporeans to undergo screening, not just for colorectal cancer, but also other cancers, as well as for chronic diseases. We recognise that ‘prevention is better than cure’. Hence, MOH and HPB have been stepping up our efforts on encouraging healthy living in the population over the past years, including having a balanced diet, doing regular physical activity, leading a smoke-free lifestyle and going for regular health screening. To further consolidate these efforts and to make healthy living accessible, natural, and effortless for all Singaporeans, MOH has developed a Healthy Living Master Plan which aims to keep Singaporeans healthy and free of illness for as long as possible through the adoption and maintenance of a healthy lifestyle.