Case Study (Male, 40 Years Old): Early Colonoscopy Screening in High-Risk Patients

Colonoscopy and the Importance of Early Screening

Colorectal cancer is one of the most common cancers in Singapore, and it remains a leading cause of cancer-related deaths. While many believe it only affects people above the age of 50, younger patients with strong family histories face significantly higher risks.

In this case study, I share how one of my patient’s experiences underscores the importance of early colonoscopy screening and how timely action could have prevented the development of colon cancer.

Patient Background: A Strong Family History of Colon Cancer

The patient was 40 years old when he was diagnosed with an early colon tumour. His medical and family history revealed high-risk factors:

• Mother: Diagnosed with colon tumours in her 50s, requiring surgical resection.
• Extended family: At least two maternal siblings affected by colorectal cancers.

This meant the patient had:

• A first-degree relative (his mother) with colon cancer.
• Multiple second-degree relatives with colorectal cancer.
  

Together, these factors placed him firmly in the high-risk category for colorectal cancer.

Missed Screening Opportunity at Age 37

When his mother was diagnosed, a detailed family history was obtained and he was advised to undergo a colonoscopy at the age of 37. Unfortunately, he did not proceed with the screening at that time.

Had the colonoscopy been done then, the growth discovered at 37 would most likely have been just a precancerous polyp. These can usually be removed during the colonoscopy itself, preventing the cancer from ever developing.

Colonoscopy at 40: Early Cancer Detected

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When a tumour is discovered in the colon, sometimes removing just the growth isn’t enough — a resection of the affected section of the colon may be needed to ensure safety and prevent recurrence.

By the time the patient eventually underwent colonoscopy at age 40, the lesion had already progressed to an early colon tumour. Though still treatable, the situation now required more complex management compared to a simple polyp removal.

Thankfully, we were able to detect his cancer at a stage where treatment was still possible, and he received the care he needed. It is an important reminder of how just a few years can make a life-changing difference, and why timely colonoscopy is critical for high-risk patients.

Key Takeaways 

1. Family History Cannot Be Ignored

Patients with one or more first-degree relatives affected by colon cancer face a significantly higher risk. In such cases, waiting until 50 to screen is too late.

2. Age Is Not the Only Risk Factor

General guidelines recommend colonoscopy from age 50, but high-risk patients often need to start earlier; typically 10 years before the youngest age of diagnosis in the family.

3. Prevention Through Polyp Removal

Detecting and removing a polyp during colonoscopy prevents progression to cancer, making early screening one of the most effective cancer prevention tools available.

Don’t Wait Until 50

This case is a strong reminder that colorectal cancer is not just a disease of the elderly. For patients with a strong family history, early colonoscopy screening is not optional — it is essential.

If you have a parent, sibling, or multiple relatives diagnosed with colorectal or related cancers, speak to your doctor about having your colonoscopy earlier.  A timely scheduled colonoscopy can mean all the difference between removing a polyp and treating a cancer.