Cancer Screening in Singapore

Cancer is the leading cause of death in Singapore with one in four people expected to develop cancer in their lifetime. While the risk of cancer can be lowered by taking mitigating actions and leading a healthy lifestyle, cancer can still strike. The chances of successfully treating are higher with early detection and treatments can be less aggressive. Cancer screening is a key element of early cancer detection for people in Singapore.

It should be noted however that cancer screening is not perfect. False negatives may error where a cancer is missed. Conversely, false positives may also occur, a normal tissue as thought to be potentially cancerous. False negatives may lead to additional unnecessary tests. There is also evidence now that cancer screening may also pick up cancers that are very slow growing (overdiagnosis bias). This may then lead to treatment when actually none is necessary.

What Cancer Screenings Do I need?

The National Cancer Centre Singapore (NCCS) cautions that it is “important to undertake cancer screening that is appropriate, evidence based and recommended by accepted guidelines” and that the Singapore Ministry of Health “has published guidelines to help guide physicians and the public as to which cancers in what group of people are appropriate for screening”.

Guidelines recommend that “average risk” people who do not have cancer symptoms or a family history of the cancer being screened for:

Colorectal Cancer

For those age 50 and above,

• Faecal occult blood testing once a year; or
• Colonoscopy once every 10 years, or
• CT colonography once every 5 years.

 Cervical Cancer

Routine screening for cervical cancer for females who have not been sexually active is not recommended since this group will rarely develop cervical cancer.

In those who have ever been sexually active, the recommendations are:

• From age 25-29: Pap smear every 3 years.
• From age 30 and above: HPV DNA test every 5 years.

Breast Cancer

There are potential downsides to breast cancer screening (mammography screening is the standard method). Consult with your doctor on screening and if deemed appropriate, the following is recommended:

• From age 40-49: Mammography screening once a year.
• From age 50-69: Mammography screening once every 2 years.

Screening For Other Cancers

For people with average risk factors, the recommended screenings above are appropriate. However, for those with additional risk factors such as family history, it may be better to undergo additional cancer screenings. You should speak to your doctor for more information on these testing if you have these additional risk factors.