Every March, the world turns its attention to colorectal cancer – a disease often undetected until it has advanced. In Brunei Darussalam, colorectal cancer remains one of the most commonly diagnosed cancers, ranking first among men and second among women.
Despite its prevalence, many still hesitate to undergo screening, a decision that can mean the difference between life and death.
Medical officer at the Brunei Centre for Disease Control and Prevention, Ministry of Health Dr Siti Zuhrini binti Haji Kahan, spoke to the Bulletin about the urgency of awareness and early detection.
THE NATURE OF COLORECTAL CANCER
“Colorectal cancer develops when abnormal cells grow in the large intestine or rectum, forming tumours that, if untreated, can spread to other parts of the body,” explained Dr Siti Zuhrini.
“The early stages of this disease are often symptomless, which is why regular screening is so important.”
Symptoms, when they do appear, include abdominal pain, changes in bowel habits, blood in stool, unexplained weight loss and persistent fatigue. However, many people dismiss these warning signs, attributing them to diet or stress.
THE ROLE OF SCREENING IN EARLY DETECTION
Colorectal cancer is one of the few cancers that can be detected in its pre-cancerous stage. “Screening is our strongest weapon,” Dr Siti Zuhrini emphasised.
“We want to find abnormalities before they turn into cancer. That’s why we introduced the Colorectal Cancer Screening Programme in 2019.”
The programme utilises the Faecal Immunochemical Test (FIT), a simple, non-invasive stool test that detects hidden blood – a potential sign of cancerous changes.
“It’s an easy test,” she assured.
“You collect a small stool sample at home and submit it to a health centre. If the results are negative, you’ll be advised to repeat the test in two years. If positive, further evaluation, including a colonoscopy, is necessary.”
WHO SHOULD GET SCREENED
According to national guidelines, Bruneians and permanent residents aged 50 to 75 who have no history of colorectal cancer should undergo screening.
“Many think they don’t need screening because they feel healthy,” Dr Siti Zuhrini noted.
“But the reality is, colorectal cancer often develops silently.”
To make screening accessible, appointments can be booked through the BruHealth app, streamlining the process. “It’s free, simple and could save your life,” she added.
Despite the simplicity of the test, participation rates remain low.
“Many people avoid screening due to fear or embarrassment,” Dr Siti Zuhrini said. “But we need to shift our mindset. This is about taking control of our health.”
Cultural stigma also plays a role. Some feel uncomfortable discussing bowel health or assume that cancer is a distant concern.
“We must normalise conversations around cancer prevention,” she stressed. “No one is immune.” While screening is vital, prevention remains key. “A healthy lifestyle can significantly reduce the risk of colorectal cancer,” said Dr Siti Zuhrini.
A diet rich in fibre from fruits, vegetables and whole grains helps maintain gut health.
Reducing consumption of red and processed meats is equally important, as studies have linked these foods to an increased risk of colorectal cancer.
PREVENTION: LIFESTYLE CHANGES THAT MATTER
Regular physical activity also plays a crucial role, helping to maintain a healthy weight and improve digestion.
Additionally, avoiding smoking and excessive alcohol intake can lower the likelihood of developing colorectal cancer. “These changes don’t just lower your cancer risk – they improve overall well-being,” she added.
BRUNEI’S SCREENING GOALS
Under the Brunei Darussalam Multisectoral Action Plan for the Prevention and Control of Noncommunicable Diseases (BruMAP-NCD) 2021-2025, the country aims to increase colorectal cancer screening rates by 50 per cent by 2025.
“We need the public’s participation to reach this goal,” urged Dr Siti Zuhrini. “Early detection means higher survival rates and better quality of life.”
As Colorectal Cancer Awareness Month continues, the message is clear: Get screened, stay informed, and prioritise your health. – Izah Azahari
