Cancer screening in Singapore, with particular reference to breast, cervical and colorectal cancer screening.

Cancer is the leading cause of mortality in Singapore, accounting for 27.1% of deaths in 2004. The most common cancers are those of the lung, colon and rectum, liver, stomach, and prostate in men; and breast, colon and rectum, lung, ovary and cervix in women. Singapore has the highest age-adjusted breast cancer incidence in Asia. National population screening programmes have been implemented for breast and cervical cancer. BreastScreen Singapore (BSS), the first population-based nationwide mammographic breast-screening programme in Asia, was launched in 2002, incorporating international standards and practice guidelines. For improved quality assurance, two-view screening mammography is carried out. From January 2002 until March 2004, BSS conducted over 84,000 screens, with an overall recall rate of 9.5%, and an overall invasive cancer detection rate of 4.48 per 1000 screened. Close to 30% of the cancers diagnosed was ductal carcinoma in situ. Papanicolaou (Pap) smear screening for cervical cancer has been available opportunistically since 1964. The national CervicalScreen Singapore programme was launched in 2004, aiming to achieve coverage of 80% of targeted women by 2010. Colorectal cancer currently has the highest incidence of all cancers in Singapore. The health authorities advocate colorectal cancer screening for the average risk population, starting from age 50 years, but in the absence of a national screening programme, the reliance is on opportunistic screening.