Opportunistic screening for colorectal neoplasia in Singapore using faecal immunochemical occult blood test.

220 INTRODUCTION The incidence of colorectal cancer in Singapore has been increasing over the last ten years. It is the most common cancer in Singapore when the combined incidences for both genders are taken into account.(1) Population-based randomised trials have shown that the use of faecal occult blood test (FOBT) reduces mortality from colorectal cancer,(2-6) with a possible reduction in cancer incidence being effected through the early detection and removal of colorectal adenomas.(7) Earlier detection of colorectal cancers may result in less invasive surgery and decreased stoma formation.(7,8) In countries such as the United Kingdom and Italy, FOBT is used in population-based national colorectal cancer screening programmes. In Singapore, a national programme for the screening of colorectal cancer was only established in July 2011, when a population screening programme was initiated by the Health Promotion Board, Singapore. However, various organisations in Singapore, the largest being the Singapore Cancer Society (SCS), have been encouraging the public to undergo voluntary screening for colorectal cancer even prior to this time by issuing free FOBT kits. Such initiatives were in addition to efforts aimed at educating the public on risk factors, symptomatology, screening, diagnosis and treatment of colorectal cancer. Since 2003, the SCS has been giving out free faecal immunochemical occult blood test (FIT) kits (OC-Light, Nagase, Singapore) to Singapore citizens and permanent residents aged 50 years and above. To date, the SCS is the largest distributor of FOBT kits in Singapore. Funding for these kits is obtained through a grant donation to the SCS. The authors contend that analyses of the results of the society’s colorectal cancer screening programme would allow us to evaluate the feasibility of a nationwide population-based screening programme in Singapore, as well as the potential obstacles that may be faced during its implementation. In addition, the results of such a study could be considered a pilot study evaluating the expected results in the local setting. The year in which the highest number of FOBT kits was given out by the SCS was 2008 (based on the years for which data were available; data from 2009 were not yet ready). Therefore, the authors aimed to analyse the results of the SCS data obtained from the opportunistic screening conducted in 2008.