Dr Yik Keng Yeong's letter ("Screening for cancers should be more targeted"; May 2) called for cancer screening to be appropriately directed.
The group of individuals that will benefit is clearly defined in practice guidelines published by our Ministry of Health (MOH), cancer control organisations and medical sub-speciality societies worldwide.
We agree that screening colonoscopy should be targeted at average-risk individuals over the age of 50, as well as younger individuals at increased risk due to a family history of colorectal cancer, individuals known to have had colonic polyps or familial polyposis syndromes, and those with a history of chronic colitis. However, we take serious issue with Dr Yik's imputation that gastroenterologists perform colonoscopy as a "precautionary measure" in order to enrich themselves.
Gastroenterologists in Singapore are sub-speciality-certified and recognised by MOH and the Singapore Medical Council after completing a three-year sub-speciality training programme, of which the training in and performance of colonoscopy forms an integral part.
The indications for screening colonoscopy are clearly stated in practice guidelines issued by bodies such as MOH, the American College of Gastroenterology and the American Cancer Society.
It is unclear what Dr Yik meant by "precautionary colonoscopy", but all gastroenterologists are required to know these indications in detail.
Unsubstantiated allegations of improper conduct should not be made against gastroenterologists in general.
Christopher Khor (Dr)
Chapter of Gastroenterologists Academy of Medicine Singapore
Lim Wee Chian (Dr)
Gastroenterological Society of Singapore