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COLORECTAL CANCER SCREENING

FREQUENTLY ASKED QUESTIONS



If I do not meet the criteria for colorectal cancer screening programme, can I still participate in other screening programmes?

If you do not meet the eligibility criteria for colorectal cancer screening programme, you may still be able to participate in the other screening programmes (cardiovascular disease risk factors screening programme, breast cancer screening programme or cervical cancer screening programme) provided that you meet the eligibility for those screening programmes.

Note: For colorectal cancer screening, the upper age limit is 75 years old unless clinically justified.


How do I prepare myself for the colorectal cancer screening (Faecal Immunochemical Test or FIT)?

You will need to collect a small sample of your stool and place it in a stool container. Please make sure that the lid of the container is intact to avoid specimen leaking. Write your name, identification card number, the collection date and time clearly on the label. Place the stool container back into the Biohazard labelled specimen bag. Seal the bag tightly. Please proceed to send the stool sample within the same day of obtaining the stool sample to the phlebotomy services counter located at your designated health centre. The sample will then be sent to the laboratory for further testing.

Reminder:

  • You can consume your regular food (no diet restrictions) and continue with your regular medications
  • If you are experiencing bleeding due to haemorrhoids (piles), blood in the urine or menstruation (period) then wait until the bleeding has stopped or ended before collecting the stool sample.

  • Are there any health risks from using the FIT kit?

    There are no risks to your health from the FIT kit. If your FIT result is positive, you will be counselled to undergo further tests, such as colonoscopy. There is a small risk that the procedure could damage your bowel, but this is rare.


    How do I get the results of my FIT?

    The results of the Colorectal cancer screening test will be explained by the health screening nurse during your follow-up appointment.

    1. If your FIT result is negative, you will be re-invited for another screening in 2 years
    2. If your FIT result is positive, you will be referred to the Gastroenterology Clinic by the Health Screening Nurse.

    If you are also participating in the Cardiovascular Disease Risk Factors Screening Programme, your test results will be informed as well.


    What is the purpose of the FIT?

    The purpose of the faecal immunochemical test (FIT) is to show whether blood is found in your stool sample. If blood is detected, your result is positive. However, it does not mean that you have bowel cancer. It may be due to other conditions such as haemorrhoids, polyps, or inflammation of the bowel. However, the cause of a positive result still needs to be investigated. You will be referred to see a doctor, who may recommend further tests, usually a colonoscopy, to find the cause.

    On the other hand, a negative result means there is no need for further investigation at the time. It does not mean that you do not have or can never develop bowel cancer as some bowel cancers do not bleed or only bleed every once in a while. In Brunei Darussalam, re-screening with FIT is recommended every two years if you have a negative result.

    Sometimes the result can be reported as invalid and this means that we would need to ask you to send another sample for retesting.


    What does it mean if I have a positive FIT result?

    If you have a positive FIT result, you will be advised for further tests, usually a colonoscopy. This is because:

  • The FIT cannot tell the difference between bleeding from bowel cancer and bleeding from other sources (e.g. bleeding from haemorrhoids).
  • A positive FIT result could mean you have bowel cancer, even if no one else in your family has had the disease.
  • A positive FIT result could mean you have bowel cancer, even if you feel you are healthy.
  • Even if you have had negative FIT results in the past, a new positive result means something has changed and you need a colonoscopy to find out why you have blood in your stool.

  • A health screening nurse will explain your result at your follow-up appointment and then he/she will refer you to the Gastroenterology Clinic for consultation on further testing, usually a colonoscopy. A colonoscopy is a procedure where a viewing tube is inserted into the colon via the anus for the purpose of looking at the colon for any abnormality. This procedure will be done under sedation.


    How accurate is the FIT result?

    No screening test is 100% accurate. There is a chance that a pre-cancerous polyp or cancer can be missed if it was not bleeding when the test was done. Regular screening gives you the best chance for early detection of colorectal cancer when treatment is more likely to be successful.


    Is colonoscopy safe?

    Colonoscopy is generally a safe procedure. However, complications can sometimes arise such as:

  • Dizziness, nausea or vomiting
  • Headache
  • Reaction to sedatives
  • Bleeding
  • Perforation - very rare (in less than 1 in 1000 cases)

  • What if I have other inquiries about this programme?

    You can email all other inquiries to health.screening@moh.gov.bn. We will respond to your inquiries the soonest possible.