Basic Health Screening Singapore – Why It May Be Insufficient Protection Against Silent Killer Diseases

An often heard lamentation by people in higher age brackets in Singapore is that they have been “going to Mandai” more frequently than they have been attending weddings (i.e. visiting the Mandai Crematorium more as peers, friends, and family pass on). Another phrase that is heard more often is “Shocking, he/she looked so fit and well just recently”. These, unfortunately, may be the result of silent killer diseases that were undetected until it was too late. In this article, we discuss why basic health screening checkups may be insufficient protection against silent killer diseases – certain cancers and coronary heart disease in particular.

Silent Killer Diseases In Singapore

Silent killer diseases common in Singapore include cancers such as stomach cancer, colorectal cancer, breast cancer, and lung cancer, as well as cardiovascular diseases such as coronary heart disease.

Learn More: Top Causes Of Death In Singapore >>

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“Silent Killer” diseases are termed as such because they often show no symptoms until they have progressed to advanced stages where treatment is more difficult. This makes it essential to understand the importance of health screenings that specifically test for them, to enable early detection, and improved treatment outcomes. This is especially so for people who have risk factors for these diseases. For instance, according to a study published in the Journal of Digestive Cancer Research, “the survival rate for colorectal cancer in Korea has increased since the start of the national cancer screening program, with the 5-year survival rate rising from 56.2% in 1993–1995 to 74.3% in 2015–2019.”

Incidence Rates of Silent Killer Diseases in Singapore

• Breast Cancer: According to the National Cancer Registry, about 2,600 new cases are diagnosed annually (2018 – 2022), making it one of the most common cancers in Singapore.
• Colorectal Cancer: Around 2,500 new cases are diagnosed each year.
• Stomach Cancer: Approximately 560 new cases are diagnosed annually.
• Lung Cancer: About 1,800 new cases are diagnosed each year.
• Coronary Heart Disease: A top killer disease in Singapore. According to the Singapore Heart Foundation, there were over 5,300 deaths principally due to ischaemic heart diseases (i.e. coronary heart diseases) in 2023.

The Limitations Of Basic Health Screening Packages In Singapore

Basic health screening packages in Singapore, costing around $100 or less, typically include:

• Blood tests for glucose, cholesterol, and liver function.
• Urine tests for kidney function and infection.
• Blood pressure measurement.
• Body mass index (BMI) calculation.
• Basic physical examinations.

These screenings give important baseline health information and can help flag out certain common health risks such as blood sugar levels and obesity (risk factor for some silent killer diseases). However, they are not sufficient to confidently detect silent killer diseases like stomach, colorectal, breast, and lung cancers, or artery blockages.

Beyond Basic Health Screening – What Else You Might Need To Screen For Each Disease

Breast Cancer Detection

Medical Imaging

• Mammography: An X-ray of the breast used to detect early signs of breast cancer, typically suitable for women aged 40-45 and above.
• Breast ultrasound: Uses sound waves to create images of breast tissue to detect tumours. It is often used as a complement to mammogram. In cases whereby the breast tissue is too dense (common for women below 40 years of age), mammography will not image well and the doctor may order the use of ultrasound in place of mammogram.
• MRI: Provides detailed images of breast tissue, especially useful for women with dense breast tissue. However, it is not common to use MRIs for screening purposes.

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Blood Tests

• Liquid Biopsies: These are blood tests for circulating tumour DNA (ctDNA) which are created by cancer cells. These allow for early cancer detection. Abnormal test results will still require further tests to confirm the diagnosis such as biopsies and medical imaging. Examples include LucenceInsight from Lucence, and SPOT-MAS from Gene Solutions.

Colorectal Cancer Detection

Physical Procedures

• Colonoscopy (lower gastrointestinal endoscopy): A procedure that allows doctors to examine the lower part of the gastrointestinal tract using a camera fix to a thin, flexible tube (endoscope). Polyps found may be extracted for biopsies and to prevent them from developing into cancer. This is widely considered a “gold standard” for colorectal cancer detection. Colonoscopy is recommended by experts for those aged 50 and above (or earlier if there are risk factors)
• Fecal occult blood test (FOBT): Detects hidden blood in the stool, which can be a symptom of colorectal cancer.

Learn More: Screenings For Stomach And Colorectal Cancers >>

Medical Imaging

• CT colonography: A CT imaging test that provides detailed images of the colon. This may be considered in place of a physical colonoscopy, but without the ability to extract polyps.

Blood Tests

• Liquid Biopsies: These are blood tests for circulating tumour DNA (ctDNA) which are created by cancer cells. These allow for early cancer detection. Abnormal test results will still require further tests to confirm the diagnosis such as biopsies and medical imaging. Examples include LucenceInsight from Lucence, and SPOT-MAS from Gene Solutions.

Stomach Cancer Detection

Physical Procedures

• Gastroscopy (upper gastrointestinal endoscopy): A procedure that allows doctors to examine the upper part of the gastrointestinal tract using a camera fix to a thin, flexible tube (endoscope). Polyps found may be extracted for biopsies and to prevent them from developing into cancer. This is widely considered a “gold standard” for stomach cancer detection.

Blood Tests

• Liquid Biopsies: These are blood tests for circulating tumour DNA (ctDNA) which are created by cancer cells. These allows for early cancer detection. Abnormal test results will still require further tests to confirm the diagnosis such as gastroscopy, medical imaging, etc. Examples include Gastroclear from MiRXES, LucenceInsight from Lucence, and SPOT-MAS from Gene Solutions.

Lung Cancer Detection

Medical Imaging

• Low-dose computed tomography (LDCT): A CT screening test that uses low-dose X-rays to detect lung cancer in its early stages. This test is recommended by experts for people (i) have a 20 pack-year or more smoking history, and (ii) currently smoke or have quit within the past 15 years, and (iii) are between 50 and 80 years old. LDCT is said to be more effective than standard chest X-rays for lung cancer detection.

Coronary Heart Disease Detection

Physical Procedures

• Electrocardiogram (ECG): A procedure that measures the electrical activity of the heart to detect heart disease.
• Exercise stress test: Measures the heart’s performance during physical activity. It usually involves walking on a treadmill or pedaling on a stationary bike while hooked up to an ECG to monitor the heart’s activity

Medical Imaging

• Echocardiogram: Uses ultrasound to create images of the heart and assess its proper function.
• CT Calcium Score: This is a CT scan that detects the amount of calcium in the walls of coronary arteries. A built-up can narrow the arteries and block the blood flow to the heart, and may lead to coronary heart disease or a heart attack.
• Coronary CT Angiography: A CT imaging test that uses X-rays to see how blood flows through the arteries in the heart. A CT Calcium Score test may be done together with the Coronary CT Angiography.

Comprehensive Health Screening Packages And Other Screening Tests

While basic health screenings are a good starting point, they are not enough to detect silent killer diseases. Comprehensive screenings (which often include advanced medical imaging options, and other specialised screening tests, are essential for early detection. A convenient point to start your search for comprehensive health screenings is out e-shop which features packages from our healthcare partners. Alternatively, you can contact us for an appointment with our partners at the button below. If you’re concerned about your health, it’s important to consult with a healthcare professional and consider more comprehensive screening options.

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