Colorectal cancer is one of the most common types of cancer in Hong Kong. The causes of colorectal cancer are generally regarded as inherited risk factors and acquired risk factors. If you have a family history of bowel diseases such as chronic colitis, colon polyps, or intestinal cancer, you are more likely to have colorectal cancer than those who do not. The acquired risk factors are associated with unhealthy lifestyles and diets. The early symptoms of colorectal cancer are subtle; they may appear in the form of anaemia, diarrhoea etc. Usually, stage II and stage III colorectal cancer will show more significant symptoms, including blood in the stool, black stool, abdominal (belly) cramping etc.
In order to raise the public awareness of colorectal cancer, the Department of Health (DOH) has implemented the Colorectal Cancer Screening Programme starting from 2020. The programme encourages Hong Kong residents aged between 50 and 75 to join the programme and receive A faecal occult blood test that detects insignificant amounts of blood in stool in any participating medical centres. The Government will subsidise further colonoscopy for high-risk individuals to prevent colorectal cancer.
Colorectal Cancer Screening is for people who do not show any symptoms of colorectal cancer (such as blood in the stool or dark-coloured stool, mucus in stool, sudden change in bowel habits etc.). It is to identify people with risk of colorectal cancer for early treatment. Participants are required to consult a Primary Care Doctor for an initial evaluation. If your medical history and physical condition are suitable for joining the programme, the medical centre will handle the enrolment procedures for you.
CRC Screening Programme eligible persons
To join the Programme, eligible persons should fulfil the following criteria:
．Aged between 50 and 75
．Hold a Hong Kong Identity Card or Certificate of Exemption
．Registered in the (eHRSS) Electronic Health Record Sharing System
Participants with the following conditions are not suitable or not necessary to enroll in the Programme:
．Record of receiving colonoscopy within the past 10 years with normal result
．Record of receiving flexible sigmoidoscopy within the past 5 years with normal result
．Record of receiving FOBT within the past 2 years with normal result
．Have symptoms of colorectal cancer
．History of colon polyps
．Have two or more first-degree relatives diagnosed with colorectal cancer
．Diagnosis of hereditary bowel syndromes, or have first-degree relative diagnosed with such syndrome
．Previously been advised against receiving colonoscopy by a doctor
Step 1: Find a primary care doctor
Step 2: Consult a primary care doctor and collect a FOBT test kit
Step 3: Collect stool specimens at home according to instructions
Step 4: Return FOBT specimens to a designated Specimen Collection Point
Step 5: Be notify with the result by primary care doctor
(Negative result) watch out for colorectal cancer symptoms and repeat FOBT every two years
(Positive result) consult with the primary care doctor for follow up and receive referral for colonoscopy
A colonoscopy is a simple exam used to diagnose lesions and diseases in the lower gastrointestinal (GI) tract, including ileum, cecum, colon, rectum and anus. It uses a 1.3cm, flexible tube with an endoscope to allow the doctor to view the inside of the entire colon. People with symptoms of colorectal cancer or who are over 50 years old without any symptoms of colorectal cancer should follow the medical advice to conduct a colonoscopy.
Causes of colorectal cancer
The exact cause of colorectal cancer is not yet identified, but certain risk factors are strongly linked to the disease according to researchers, including poor dietary habits, lifestyle and family history. They include:
．Excessive consumption of animal fats
．Excessive consumption of protein
．Insufficient intake of dietary fibre
．Obesity, lack of exercise
．Smoking, alcohol consumption
．Have blood relatives diagnosed with colorectal cancer
Colorectal Cancer Treatments
The treatment for colorectal cancer is usually a removal surgery for the cancerous tumour and the surrounding intestinal segments. The physician will adopt a suitable treatment for the patient based on the size and shape of the cancer, and its spreading. The treatment for colorectal cancer is usually a removal surgery for the cancerous tumour and the surrounding intestinal segments. The physician will adopt a suitable treatment for the patient based on the size and shape of the cancer, and its spreading.
The medical team may adopt chemotherapy (chemo) based on the patient’s condition, a treatment that dissolves powerful chemicals into the blood to kill the cancer cells and avoid cancer recurrence.
Governmental Subsidisation and Additional Fees
In order to raise the awareness towards colorectal health, The DOH has fully subsidised the eligible to consult a primary care doctor and conduct a FOBT. There is no additional charge for eligible persons. Contact us to make an appointment now.
If the FOBT result of the participants is positive, the government will offer another HKD$7,800 (without colon polyps) or HKD$8,500 (includes polyp removal surgery) to conduct a colonoscopy. Subsidisation includes the fees for the pre-screening consultation, colonoscopy (including fees for anaesthesia), and polyp removal (if any). Participants will only have to pay an additional fee of not more than HKD $1,000 after subsidisation.
Colonoscopy Result
The doctor will discuss the colonoscopy result with you. The result is regarded as normal, if there is no suspicious condition in the bowel wall; if it is abnormal, the doctor will explain the report to you and formulate an proper treatment plan for you.
FAQ for Colorectal Cancer Screening Programme (CRC)
1. 1. Can I join the programme if I have haemorrhoids ?
You can join the programme and conduct a FOBT as long as the pile does not bleed. If it does, please seek medical assistance as soon as possible.
2. What happens if I lose/break one of the FOBT tubes?
If you lose/break one of the two FOBT tubes, you should still carry out stool specimen collection for the remaining FOBT tube. You should contact your Primary Care Doctor for a replacement if you lose or break both tubes.
3. How do I submit the specimen?
You will have to put the FOBT tube in a small plastic bag and seal it in the bigger bag which has the specimen form on it. You should return it to a designated specimen collection point within 4 days of its collection.
4. The result of my FOBT screening is positive, do I have colorectal cancer?
A positive FOBT result means that blood is detected in your stool. This can be due to a number of other conditions apart from colorectal cancer. You should discuss with your doctor regarding further investigations to look for the cause of the bleeding.
5. Can a colonoscopy be carried out on the same day?
The colonoscopy requires a 6-hour fasting period before the colonoscopy to make sure there is nothing in your intestines that will interrupt the exam. Therefore, an appointment for a colonoscopy has to be made at least one day before. A regular procedure will be having a consultation with your doctor first and your doctor will arrange the most suitable tests and treatments for you based on your condition.
6. Does a colonoscopy require a hospital stay?
Colonoscopy is a simple exam that only requires the patient to spend a half day in the daytime medical centre to conduct the exam.
7. Can I use a Health Care Voucher in settling the co-payment?
The programme is subsidised by the Department of Health so health care vouchers cannot be used to settle the co-payment.
