[Perspectives] Singapore Prostate Cancer Statistics And Lessons

Cancer, a word that strikes fear in the hearts of many, is a reality that Singaporeans face. Most adults in Singapore would have had a family member or a friend contract cancer. This Editor is no exception, who has recently learnt that an old friend now has prostate cancer in an advanced, metastasised stage. This article delves into the statistics of cancer in Singapore, with a particular focus on Singapore prostate cancer statistics and the lessons we can draw from them.

The Prevalence Of Cancer In Singapore

The prevalence of cancer in Singapore has been on the rise over the years. with 49% and 51% of cases reported in males and females respectively. From 2017 to 2021, 84,002 cancer cases were reported in Singapore. About 1 in 4 people are expected to contract cancer in their lifetime.

The three most frequent incident cancers reported for males in this period are prostate, colorectal, and lung cancers. For females, the most common cancers are breast, colorectal, and lung cancers.

A Closer Look at Prostate Cancer

Prostate cancer is the most common cancer among men in Singapore. From 2017 to 2021, there were 6,912 reported cases of prostate cancer, accounting for 16.8% of all male cancer cases.

Prostate cancer develops when cells in the prostate gland undergo uncontrolled growth, forming a malignant lump and invading the surrounding tissue. The growth rate of prostate cancer varies among men. In some men, prostate cancer develops slowly and may not cause any problems in their lifetimes. In others, it develops quickly and aggressively spreads to other parts of the body.

There are various types of prostate cancer. Adenocarcinoma makes up 95% of all prostate carcinoma, with the Acinar subtype being predominant. This cancer originates and develops in gland cells that make prostate fluid. There is also Ductal adenocarcinoma, which is a subtype that starts in the cells lining the ducts of the prostate gland. This subtype is usually more aggressive compared to the Acinar subtype, with a faster rate of growth and spread.

Aggressive forms of Prostate cancer that are not Adenocarcinoma include Small-cell carcinoma (a type that usually has already spread to other parts of the body, such as the bones, by the time it is diagnosed), and Squamous cell carcinoma.

Prostate cancer symptoms may present only at the later stages, with earlier stages being asymptomatic typically.

Mortality Rate of Early Stage and Advanced Stage Prostate Cancer

The mortality rate of prostate cancer varies depending on the stage of the cancer at diagnosis. For early or locally advanced cancers (Stages I through III), the survival rate is close to 100% at 5 years from diagnosis. However, for metastatic cancers, the survival rate decreases significantly to around 30%.

According to the National Cancer Registry, for the period 2018-2021, only 14.9% of prostate cancer incidences were diagnosed at Stage I, and 31% at Stage IV.

Detection Via Health Screening

Early detection of prostate cancer allows for timely medical intervention.

There is currently no national screening programme for Prostate Cancer in Singapore. Risk factors for prostate cancer include age (the chances of prostate cancer increase with age), race (Asians have a lower risk of developing prostate cancer, as compared to Caucasians and people of African origins), and family history.

The Ministry of Health considers men above 50 years of age and has a family history of prostate cancer diagnosed below 60 years of age to be of higher risk for prostate cancer. MOH recommends screening for these higher risk group.

The screening may involve a digital rectal examination (DRE) or a Prostate Specific Antigen (PSA) blood test.

Should You Get Screened For Prostate Cancer?

While the statistics are sobering, it is important to remember that early detection may significantly improve the prognosis of prostate cancer. Regular health screenings can help detect prostate cancer in its early stages, allowing for more effective treatment and a better chance of survival.

If you fall into the high-risk group, screening should seriously considered. However, the choice may be less clear if you do not have the risk factors. Screening is not perfect and there is the possibility of false-positives, which may cause undue worry, stress and expenditure for follow up tests. PSA screening tests can be found in many affordably priced health screening packages, or may possibly be done by itself. The direct cost of taking a PSA test thus ought not be an impediment for most people in Singapore.

If you have concerns about the possibility of prostate cancer, you should see a doctor or a urologist for a consultation and advice.

Health Screening Packages Under S$500 With PSA Tests

For non-fasting, convenient health screening across selected MinMed clinics islandwide:

For a suite of blood tests specifically for various types of cancer, including GASTROClear test for stomach cancer:

Our Partner Doctors – Urologists In Singapore

If you are looking for urologists in Singapore, we have some partners that you can consider – Dr Terence Lim, Senior Consultant Urologist, and Dr Fiona Wu, female Senior Consultant Urologist.