Warning Signs of Colon Cancer Men Often Brush Off

Warning Signs of Colon Cancer Men Often Brush Off

Blood in stool, bowel habit changes, and abdominal discomfort are signs men often dismiss. Find out when to get checked and how a simple test like the Faecal Immunochemical Test (or FIT) could make all the difference.

It might start as stomach discomfort or a change in bowel habits that is easy to chalk up to stress or last night’s dinner. Nothing that seems worth worrying about. But for some men, that assumption is how colorectal cancer slips through unnoticed.  

Colorectal cancer is one of the most common cancers affecting 37.5 per 100,000 men in Singapore, particularly among Singaporean Chinese. Yet, many early warning signs are missed because they feel too ordinary to be alarming.

Rectal bleeding – blood in the stool or on toilet paper after wiping – is often assumed to be due to piles. Abdominal discomfort is blamed on stress, spicy food, irregular meals or “something I ate”. A change in bowel habits is watched for a while, then forgotten when things seem to improve.

According to Dr Darius Aw, Consultant, Department of Colorectal Surgery, Sengkang General Hospital, delayed presentation is common when symptoms are mild, painless or intermittent. Many men notice the symptom, give it a familiar explanation, and wait for it to pass.

In an Asian study of adults aged 40 and above with rectal bleeding, 60 per cent delayed seeing a doctor, and only two out of 80 patients thought cancer could be a possible cause. The gap between noticing a symptom and acting on it is where risk begins.

When recurring bowel symptoms need medical attention

Many early symptoms of colorectal cancer overlap with common digestive issues. Bleeding may happen after constipation, bloating after a heavy meal, and bowel changes due to stressful work periods or travel.

These explanations are not always wrong – the concern arises when they become the only explanation, especially when symptoms persist, recur or feel different from usual.

Rectal bleeding is a common example. It is often attributed to piles, constipation or “heatiness”, especially if it stops for a few days. While a temporary improvement can feel reassuring, bleeding that comes and goes should not be ignored.

Do not assume rectal bleeding for piles

What concerns Dr Aw most is the misconception that rectal bleeding is almost always due to piles. Piles can cause bleeding, and many people do have them. However, not every episode is harmless. A person can also have piles and another condition in the colon or rectum at the same time.

Another common assumption is that symptoms of cancer must be obvious. Many people expect severe pain, heavy bleeding, or sudden weight loss before taking symptoms seriously. Early colorectal cancer can be silent, or cause only traces of blood, mild abdominal discomfort, unexplained tiredness or barely noticeable changes in bowel habits.

While most symptoms may not point to cancer, getting properly assessed provides peace of mind and ensures more serious cases are not missed.

Who should be more proactive

Men aged 50 and above should make screening a priority, as colorectal cancer risk increases with age. Some should speak to their doctor earlier, especially those with a family history of colorectal cancer, a history of colon polyps, or inflammatory bowel disease.

Ethnicity can also play a role. As colorectal cancer is more common among Chinese Singaporean men, regular screening and early symptom checks are especially important for this group.

While screening recommendations are based on age and risk profile, symptoms are a different matter. Men below 50 who has rectal bleeding, persistent bowel changes, unexplained weight loss, anaemia, or a strong family history should still seek medical advice rather than wait until they reach the usual screening age.

4 myths that delay diagnosis and treatment

"I feel healthy, so I do not need screening."

Screening is suitable for people who feel well. Early colorectal cancer may not cause symptoms, and some polyps can remain in the colon for years before turning into cancer. Feeling well is reassuring, but it is not a reason to skip screening when you are of the recommended age.

"I am too young to get colon cancer."

Colorectal cancer is more common after 50, but younger adults can still develop it. Symptoms deserve attention at any age, especially rectal bleeding, persistent bowel changes, unexplained weight loss, anaemia, or a strong family history.

"I exercise and eat well, so I cannot get it."

A healthy lifestyle helps reduce risk, but it does not remove risk completely. Exercise, balanced eating, maintaining a healthy weight and not smoking are important, but they should work together with screening and symptom awareness.

"Colonoscopy is painful and dangerous."

For most patients, colonoscopy is more manageable than expected. The bowel preparation is usually the most uncomfortable part, as it involves drinking a cleansing solution to clear the bowel before the procedure.

Sedation is commonly given during colonoscopy, and most patients do not feel significant pain. The procedure is worth considering because it can detect cancer and remove polyps before they become cancer. Serious complications are uncommon.

FIT kit makes screening easier to start

The Faecal Immunochemical Test, or FIT kit, is a simple, non-invasive test that detects hidden blood in your stool. You can pick up a kit at any CHAS GP Clinic, if eligible for subsidised Healthier SG screening.

The simple FIT test can be done at home – a small stool sample is collected using the provided applicator, sealed in the test tube, and returned to a clinic. No scope, injection or hospital procedure is required, and it can pick up tiny traces of blood that is not visible to the eye.

A positive FIT result does not mean cancer has been discovered. It just means further investigations, such as a colonoscopy may be needed to find the source of the bleeding.

● For those who are well and of screening age, the FIT kit is a simple, fuss-free way to test one’s colorectal health.
● For those with persistent symptoms, a medical consultation is important to have, even if they are younger than the usual screening age.
● Check out the Healthier SG programme, to see if you are eligible for subsidised FIT screening.

Early assessment gives more options

Many avoid seeking consultation because of the fear of receiving bad news. While understandable, avoiding the test does not make a problem disappear. It only delays the answer.

If the symptom turns out to be minor, getting checked brings peace of mind. If something suspicious or serious is found, earlier detection gives doctors more treatment options and may mean more straightforward treatment with better outcomes.

Start with one small step: speak to your general practitioner or polyclinic doctor, ask about FIT screening if you are eligible, or get persistent symptoms checked. You do not need to have all the answers before seeing a doctor – this is what the consultation is for.