More cancer patients in Singapore die, compared with US, S. Korea: Paper

Age at diagnosis, lower screening rates among possible reasons, say doctors

- Salma Khalik

More than double the number of cancer patients in Singapore die of the disease compared with those in Australia and the United States. In Asia, Singapore also fares worse than South Korea and Japan in terms of cancer survival rate.

Doctors say factors such as age at diagnosis, screening take-up rates and access to care are among possible reasons for the lower survival rate here.

A paper published by the Asia-Pacific Medical Technology Association (ApacMed) in June showed that 51 out of 100 cancer patients in Singapore die, compared with 24 in Australia, 25 in the US, 38 in South Korea and 41 in Japan.

The paper suggests that countries with higher cancer mortality rates are the ones with lower use of next-generation sequencing (NGS), a test that identifies biomarkers in cancers that can be targeted with specific treatments, resulting in better outcomes.

ApacMed, which represents manufacturers and suppliers of medical equipment, devices and in-vitro diagnostics, clearly has an interest in pushing for NGS.

The paper admits that "there is an absence of current studies establishing a causal relation between mortality-to-incidence ratio and variations in NGS access".

However, it points out that there have been several studies showing better patient outcomes in countries where there is reimbursement for NGS, such as in South Korea for colorectal and non-small cell lung cancer.

Associate Professor Ravindran Kanesvaran, who chairs the division of medical oncology at the National Cancer Centre Singapore (NCCS), said: "While NGS has demonstrated potential as a tool that improves our understanding of a patient's tumour characteristics, it is inaccurate to say that its widespread implementation will have any impact on a nation's overall cancer mortality."