Cancer screening: national recommendations and beyond
Singaporeans are eligible for breast and cervical cancer screening at subsidised rates at polyclinics under the HealthySG program.
Nationwide cancer screening programs target common cancers like breast, colorectal, and cervical cancer, following evidence-based guidelines to detect disease early in high-risk populations. These programs are cost-effective and widely accessible but may not cover less common cancers or provide individualized risk assessment. In contrast, some patients opt for additional cancer screening, such as tumour markers, multi-cancer early detection (MCED) tests, (DNA and RNA based) seeking peace of mind or early detection beyond standard guidelines. While this approach may detect cancers earlier, it can lead to false positives, and overdiagnosis, potentially resulting in unnecessary procedures and costs. A balanced approach, considering personal risk factors and medical guidance, is key.
Breast cancer
- Women above 40: yearly mammogram after discussion with their doctor.
- Women above 50: mammogram every 2 years is recommended
Cervical cancer
- Women aged 25-29: Recommended to undergo Pap smear every 3 years.
- Women aged 30 and above: Recommended to undergo HPV DNA test every 5 years. There are also self-test kits available! ($150 SGD at our clinics).
Breast cancer
- Women above 40: yearly mammogram after discussion with their doctor.
- Women above 50: mammogram every 2 years is recommended
Lung cancer
- For ex-smokers or current smoker: annual low dose CT scan
Nasopharyngeal cancer
- With a family history: EBV immunoglobulin screen and flexible nasoendoscopy
Prostate cancer
- Men above 50: yearly PSA test after discussion with their doctor on the pros and cons.
Colorectal cancer
- Fecal occult blood: self-test kit to be done yearly above 50 years old. If positive, for colonoscope.
- Colonoscope: done after 50 years old for average-risk individuals, once normal, only requries 5-10 yearly scope.
Blood cancer markers
- Pancreas (CA 19-9)
- Lung (Cyfra 21-1)
- Nose (EBV EA+EBNA-1 IgA)
- Liver (AFP)
These are cost-effective and convenient. However, they can lack specificity and sensitivity. Some non-cancerous conditions can result in elevated markers too. And some cancers do not secrete cancer markers.
Multi-Cancer Early Detection (MCED)
Multi-Cancer Early Detection (MCED) refers to blood-based tests that detect multiple types of cancer at an early stage by identifying tumor-derived signals like cancer DNA, RNA fragments circulating in the blood.
This is highly specific ( if these fragments are detected, there is a very high chance of an actual cancer). However, MCED is more costly, and because of its novelty, there are no standard guidelines available.
Tests available in our clinics
- Lucence Insight 5
- Lucence Insight 7
- Lucence Insight 12
- Lucence Insight 50