Colorectal Cancer Screening in Singapore: Tests, Ages and Who Needs It

Last updated: 25 Oct 2026

Colorectal cancer (cancer of the colon or rectum) is one of the most common cancers in Singapore.[1] In its early stages it often causes no symptoms at all, which is why screening matters: it looks for signs of cancer, or the polyps that can turn into cancer, in people who feel well.[1][2] This guide explains who should be screened, the main screening tests, what an abnormal result means and when you should see a doctor instead of waiting for screening.

Why screening for colorectal cancer matters

Most colorectal cancers develop slowly over several years. They usually start as a polyp, a small non-cancerous growth on the inner lining of the bowel. Not every polyp becomes cancer, but some types can change over time.[1]

Screening helps in two ways:

• Finding cancer early, often before symptoms appear, when it may be easier to treat.[2][3]
• Finding and removing polyps before they have a chance to become cancer. Polyps found during a colonoscopy can usually be removed during the same test.[3]

Screening does not stop you from ever getting bowel cancer, but it is one of the most effective ways to catch it at an early stage.[2]

Colon cancer screening age: when should you start?

National guidance in Singapore depends on your level of risk.[1]

Average risk

You are generally considered at average risk if you:[1]

• have no symptoms or signs of colorectal cancer, and
• have no family history of colorectal cancer, or only have it in more distant relatives (not parents, brothers or sisters), or in close relatives who were diagnosed after the age of 60.

For people at average risk, screening should begin at age 50.[1] The two main recommended options are a yearly faecal immunochemical test (FIT) or a colonoscopy at longer intervals.[1]

Increased or high risk

Some people need to start earlier or be screened more often, usually with a colonoscopy. Singapore guidance lists groups such as:[1]

• people with a parent, brother or sister who had colorectal cancer, especially if they were diagnosed at age 60 or younger, or if two or more close relatives were affected
• people whose close relative had certain advanced polyps
• people with a personal history of colon polyps or of inflammatory bowel disease (ulcerative colitis or Crohn's disease)
• families with inherited conditions such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colorectal cancer).

For example, if a parent or sibling was diagnosed at age 60 or younger, HealthHub advises starting colonoscopy screening at age 40 or ten years before the youngest affected relative's diagnosis, whichever is earlier.[1] If you think you might be in a higher-risk group, discuss it with a doctor, who can work out when you should start and which test suits you.

Colorectal cancer screening tests

Faecal immunochemical test (FIT)

The FIT test checks a small sample of stool for tiny amounts of blood that you cannot see. Bleeding can be a sign of polyps or cancer.[1][2]

• It is done at home: you collect stool samples using a kit and return them for testing.[1][2]
• Under Singapore's national programme, you are given two FIT kits so that two samples can be collected on separate days, which gives a more accurate result.[1]
• For people at average risk, FIT should be repeated once a year.[1]
• Singapore Citizens can get FIT screening through HPB's Healthier SG Screening programme at participating CHAS GP clinics.[1][5]

FIT is simple and non-invasive, but it is a screening test, not a diagnosis. A positive result means blood was found and needs to be investigated, usually with a colonoscopy. A normal result does not completely rule out cancer, which is why the test is repeated regularly.[2]

Colonoscopy

A colonoscopy uses a thin, flexible tube with a camera to look at the whole of the large bowel. It is the main test used to follow up an abnormal FIT result, and it can also be used as a first-line screening test.[1][3]

• For people at average risk, Singapore guidance says a screening colonoscopy should be done at an interval of no more than 5 to 10 years.[1]
• It is the recommended screening test for most people in the increased and high-risk groups.[1]
• Polyps can usually be removed during the test, and tissue samples (biopsies) taken if needed.[3]

Colonoscopy needs bowel preparation beforehand and is usually done with sedation. Our colonoscopy patient guide explains how to get ready and what to expect, and our article on polyp removal explains what happens if a polyp is found.

Other tests

Other options are used in some countries or situations:[3]

• Flexible sigmoidoscopy looks at the rectum and lower part of the colon only.
• CT colonography (sometimes called virtual colonoscopy) uses a CT scan to create images of the bowel. If it finds something, a colonoscopy is still needed.
• Stool DNA tests look for changes in DNA from cells in the stool, as well as blood.

These are less commonly used for routine screening in Singapore, where FIT and colonoscopy are the main recommended tests.[1] A doctor can explain whether any of them suits your situation.

FIT or colonoscopy: which is right for you?

Sources: [1][2][3]

The right test is often the one you will actually do and keep up with. People at average risk can usually choose either; people at higher risk are generally advised to have a colonoscopy.[1] A doctor can help you weigh up the options based on your age, family history and preferences. For an overview of how the two endoscopy tests differ, see gastroscopy vs colonoscopy.

What happens if your FIT result is positive?

A positive FIT result does not mean you have cancer. Blood in the stool can come from many causes, including piles, polyps or inflammation.[2] But it does need to be investigated, usually with a colonoscopy, so the cause can be found.[1][2] Don't simply repeat the FIT test or wait for next year's screening.

Symptoms mean see a doctor, not wait for screening

Screening is for people without symptoms. If you have any of the following, see a doctor rather than waiting for a screening test, even if a previous FIT result was normal:[1][4]

• blood in your stool or bleeding from the back passage
• a change in your usual bowel habit, such as looser stools, constipation or going more often, that doesn't settle
• tummy pain, bloating or a lump in your tummy
• unexplained weight loss or tiredness, or signs of anaemia.

These symptoms are often caused by something less serious, but they should be checked. Our article on blood in stool explains common causes and when to seek urgent care.

Lowering your risk of colorectal cancer

Some risk factors, such as age and family history, can't be changed. Others can. HealthHub links a higher risk to smoking and to a diet high in fat and low in fruit and vegetables.[1] It also helps to:[6]

• eat a healthy diet with plenty of fruit and vegetables, and less red and processed meat
• stay active and lose weight if you're overweight
• stop smoking and drink less alcohol
• know your family history and share it with your doctor[1]
• keep up with screening once you reach the recommended age.[1]

Talking to a doctor about screening

If you're unsure when to start screening, which test suits you, or what to do after an abnormal result, a gastroenterologist can assess your risk and explain the options. For information on the endoscopy procedures offered at the clinic, see our Colonoscopy and Gastroscopy service page. Questions about scheduling, fees or insurance are best discussed with the clinic directly, through our contact form or the appointment request form.

Frequently asked questions

At what age should I start colorectal cancer screening in Singapore?

For people at average risk, Singapore guidance recommends starting at age 50. People with a strong family history, a personal history of polyps or inflammatory bowel disease, or an inherited condition may need to start earlier.[1]

How often should I do a FIT test?

For people at average risk, FIT should be done once a year. Two stool samples are collected on separate days for a more accurate result.[1]

Is a FIT test as good as a colonoscopy?

They do different jobs. FIT is a simple home test that looks for hidden blood and is repeated yearly. Colonoscopy looks directly at the whole bowel and can remove polyps, but it needs bowel preparation and is usually done with sedation. Both are recommended screening options for people at average risk.[1][3]

What should I do if my FIT result is positive?

See a doctor. A positive result means blood was found in the stool, which needs to be investigated, usually with a colonoscopy. It does not mean you have cancer.[1][2]

I have a family history of colon cancer. When should I be screened?

It depends on who was affected and at what age. If a parent, brother or sister was diagnosed at age 60 or younger, HealthHub advises colonoscopy screening from age 40 or ten years before the youngest relative's diagnosis, whichever is earlier. Discuss your family history with a doctor.[1]

I have symptoms but my last FIT test was normal. Should I wait?

No. Screening is for people without symptoms. If you have blood in your stool, a change in bowel habit or unexplained weight loss, see a doctor even if a recent FIT result was normal.[1]

Sources

1. HealthHub (HPB). Colorectal Cancer: Understand the Risk Factors, Symptoms and Different Screening Methods. https://www.healthhub.sg/health-conditions/colorectalcancer
2. NHS. Bowel cancer screening. https://www.nhs.uk/tests-and-treatments/bowel-cancer-screening/
3. National Cancer Institute. Colorectal Cancer Screening (PDQ®) – Patient Version. https://www.cancer.gov/types/colorectal/patient/colorectal-screening-pdq
4. NHS. Bowel cancer: Symptoms. https://www.nhs.uk/conditions/bowel-cancer/symptoms/
5. HealthHub. Understanding More About Healthier SG Screening (FAQ). https://www.healthhub.sg/programmes/healthiersg-screening/screening-faq
6. NHS. Causes of bowel cancer. https://www.nhs.uk/conditions/bowel-cancer/causes/