Recommendations of the Cancer Expert Working Group (CEWG) on Cancer Prevention and Screening
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The Government established the Cancer Coordinating Committee (CCC), which is chaired by the Secretary for Food and Health, and comprises members including cancer experts, academics, doctors in public and private sectors, as well as public health professionals, for effective prevention and control of cancer.
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In 2002, the CEWG was set up under the CCC to regularly review and discuss latest scientific evidence, local and worldwide, with a view to providing recommendations on suitable cancer prevention and screening measures for the local population.
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In 2010, based on comprehensive review of local and international scientific evidence, the CEWG published a set of revised recommendations on breast, colorectal and prostate cancer prevention and screening. After considering local epidemiology and the latest scientific evidence, the recommendations were reaffirmed in November 2012 and fine-tuned in June 2016, October 2017 and November 2021. Its recommendations on prevention and screening for colorectal cancer are as follows :
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The general public
The CEWG recommends individuals aged 50 to 75 to discuss with their doctor and consider screening for colorectal cancer by one of the following methods:
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faecal occult blood test every one or two years; OR
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flexible sigmoidoscopy every five years, OR
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colonoscopy every 10 years.
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People with increased risk
The CEWG recommends individuals with increased risk to consult their doctor and start screening for colorectal cancer at an earlier age and have screening repeated at shorter time intervals as recommended by their doctor. People with increased risk include those who have:
- mutated gene of hereditary bowel diseases such as familial adenomatous polyposis or Lynch Syndrome;
- one first-degree relative (parent, sibling or children) diagnosed with CRC at or below 60 years of age; or
- more than one first degree relatives diagnosed with CRC irrespective of age at diagnosis.
- Recommendation on genetic testing for CRC: For family members of CRC patients with identifiable genetic mutations, two-tier screening by genetic testing followed by endoscopic examination can be offered to reduce the number of unnecessary investigations, as well as to reduce the risk of potential complications.
- After taking into consideration scientific evidences, overseas screening guidelines and practices, the CEWG revised the recommendations on CRC screening in 2021 which are highlighted below –
- For individuals with one first degree relative diagnosed with CRC at or below 60 years of age, or more than one first degree relatives with CRC irrespective of age at diagnosis, and without hereditary bowel syndromes, screening for CRC by colonoscopy every five years beginning at the age of 40 or ten years prior to the age at diagnosis of the youngest affected relative, but not earlier than 12 years of age is recommended. As an alternative, the individuals at increased risk may consider Faecal Immunochemical Test (FIT) every one or two years after understanding the pros and cons of FIT as compared with colonoscopy.