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The Singapore National Breast Screening Programme: principles and implementation
1Department of Diagnostic Radiology, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074.
Annals of the Academy of Medicine, Singapore
|September 13, 2003
Summary
The Singapore Breast Screening Project demonstrated that mammography effectively detects earlier stage breast cancers and ductal carcinoma in situ in Singaporean women. This led to the establishment of the national breast screening program, BreastScreen Singapore.
Area of Science:
- Oncology
- Public Health
- Radiology
Background:
- Breast cancer is a leading cause of death for women in Singapore, with incidence rates rising and shifting towards Western patterns.
- Singapore has one of the highest age-adjusted breast cancer incidences in Asia, particularly in the 45-49 age group.
Purpose of the Study:
- To evaluate the effectiveness of mammographic screening in Singaporean women.
- To inform the development of a national breast screening program based on international standards.
Main Methods:
- The Singapore Breast Screening Project (1993-1996) analyzed mammographic screening outcomes.
- The Singapore National Breast Screening Programme (launched 2002) adopted a distributed mammography model with centralized reading and assessment.
Main Results:
- Mammographic screening shifted detected breast cancers to smaller sizes and earlier stages.
- Screening significantly increased the detection rate of ductal carcinoma in situ.
- Acceptable rates of recall, needle biopsy, and interval cancers were observed.
Conclusions:
- Mammographic screening is effective in early breast cancer detection in Singapore.
- The findings supported the establishment of the BreastScreen Singapore program, the first population-based mammographic screening program in Asia.
- The program utilizes a unique co-payment model and adheres to international screening standards.