Singapore is facing a growing challenge with cancer, now the leading cause of death in the nation. While advancements in treatment are improving survival rates, oncologists are increasingly focused on the impact of lifestyle factors, despite robust prevention policies already in place. A recent World Health Organization (WHO) study revealed that nearly four in ten cancer cases globally are linked to preventable causes, including smoking, alcohol consumption, and air pollution, findings that resonate with the situation in Singapore.
The interplay between Singapore’s urbanized lifestyle and cancer risk is a key concern. Experts emphasize that a multifaceted approach, encompassing effective screening programs and modifications to lifestyle habits, is crucial to curbing the rising incidence of the disease. Addressing these factors is particularly important as Singapore’s population continues to age, a demographic trend that naturally increases cancer risk.
According to the 2023 Global Burden of Disease study, published in 2025, 32.8% of years of healthy life lost to cancer in Singapore could be averted by eliminating all risk factors. Tobacco use and an unhealthy diet were identified as significant contributors to this loss.
Successes and Emerging Challenges in Cancer Prevention
Singapore has seen success in reducing certain cancers through targeted public health initiatives. Universal hepatitis B vaccination, introduced in the 1980s, has demonstrably reduced the incidence of liver cancer in younger generations, as the vaccinated cohort reaches middle age. Similarly, improved coverage of the human papillomavirus (HPV) vaccine, offered free to female Secondary 1 students since 2019, is expected to significantly lower rates of cervical cancer in the coming decades.
However, these successes are tempered by emerging challenges. Despite stringent tobacco control measures – including consistently high taxes on tobacco products, recently increased by 20% – a concerning trend has emerged: a significant proportion of lung cancer patients in Singapore have never smoked. Approximately 48% of local lung cancer patients are non-smokers, a rate considerably higher than the 10-20% observed in Western nations.
Dr. Gloria Chan, a consultant with the haematology-oncology department at the National University Cancer Institute, Singapore (NCIS), explained that this phenomenon is particularly prevalent among Asian women and is often driven by genetic alterations, most commonly mutations in the epidermal growth factor receptor (EGFR) gene. These mutations are known to be more common in Asian populations. Current lung cancer screening guidelines in Singapore focus on individuals aged 50-80 with a history of at least 20 pack-years of smoking, leaving a substantial portion of non-smokers unaddressed.
Low Screening Rates and the Rise of Lifestyle-Related Cancers
Beyond lung cancer, screening rates for other common cancers in Singapore remain relatively low. According to the latest National Population Health Survey, only 35.2% of women aged 50 to 69 undergo regular mammograms for breast cancer screening. This is significantly lower than rates observed in countries like Britain, New Zealand, and Sweden, where participation ranges from 70 to 90%. Screening rates for cervical and colorectal cancers stand at 44.9% each, also below the commonly cited 70% target for effective population-level screening. These lower rates could lead to later-stage diagnoses, potentially impacting survival outcomes.
Alongside these challenges, oncologists are increasingly concerned about the impact of obesity and metabolic syndrome – a cluster of conditions including high blood pressure and high blood sugar – on cancer risk. The 2024 National Population Health Survey reported that obesity in Singapore has risen to 12.7%. Excess weight is linked to an increased risk of several cancers, including colorectal, breast, endometrial, gastric, and pancreatic cancers, highlighting the need for sustained public health efforts in this area.
Looking Ahead: A Holistic Approach to Cancer Control
While prevention efforts will continue to be vital, Assistant Professor Dawn Chong, a senior consultant with the medical oncology division at the National Cancer Centre Singapore, notes that even with strong prevention strategies, the total number of cancer cases may still rise due to Singapore’s rapidly aging population. The key metric for success, she emphasizes, is a decline in the age-adjusted incidence rate.
Effective cancer control requires a holistic approach that extends beyond medical care. As Professor Chong stated, it necessitates strong public health programs, safer environments, and collaborative community efforts to foster a healthier society. The Healthier SG initiative, which provides free cancer screening for eligible individuals, is a step in this direction.
Disclaimer: This article provides informational content and should not be considered medical advice. Please consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
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