Sharp rise of breast and prostate cancers in Singapore

But better treatment regimes have raised survival rates significantly for breast cancer patients


Two cancers have been rising sharply in Singapore: breast cancer in women and prostate cancer in men. Over the past 40 years, the incidence of breast cancer here has more than doubled – from 25 to 65 per 100,000 women. Over the same period, prostate cancer has gone up fivefold – from six to 30 per 100,000 men.
 

For women, breast cancer is not just the most common cancer, accounting for one in three cancers in women, but it is also the top killer. The latest cancer registry report released last month showed that 2,105 women died of breast cancer between 2011 and 2015. More than half the women were diagnosed between the age of 45 and 64 years.
 

The good news is that 71 per cent were diagnosed in the early stages, giving them a high chance of survival. Those in stage 1 have a 91 per cent chance of surviving beyond five years, compared with 20 per cent for those discovered at stage 4. The report said: "There was a significant increase in the survival of breast cancer patients from the period 2006-2010 to 2011-2015, likely due to improvements in treatment regimes."
 

This is why the death toll for breast cancer has remained fairly stable in spite of the sharp upward trend in incidence. The report added that survival was "noticeably better" among Chinese women, who are also those at highest risk of getting this cancer.
 

Prostate cancer now makes up one in seven cancers in men, and is the third most common cancer for them, up from seventh place 40 years ago. In the five years from 2011 to 2015, 4,053 were diagnosed with this cancer, and 795 died of it.
 

Dr Raymond Ng of the National Cancer Centre Singapore said the rise of breast and prostate cancers is "expected for a country that has become wealthier" as its people would be more sedentary and overweight, increasing their risk of cancers. Overall, colorectal cancer remains the top cancer here, although the rates have been decreasing gradually over the past 15 years.
 

However, more than half the 9,807 people diagnosed between 2011 and 2015 were in the late stage, with poorer chances of survival. Although better treatments have resulted in higher survival rates, 3,906 people died of colorectal cancer in that five-year period.
 

Dr Tan Ker Kan of the National University Cancer Institute Singapore is particularly concerned that one in five diagnosed with colorectal cancer was younger than 55 years old. These younger patients are often diagnosed when they turn up at the hospital's emergency department, with three in five already in the advanced stages. He said: "There is a need to raise awareness among younger adults that it is possible to have colorectal cancer at a younger age and to seek medical help earlier, as early detection means better outcomes."
 

More than half the cancer deaths here comes from just four cancers: lung, breast, colorectal and liver. They accounted for 13,796 of the 26,661 cancer deaths between 2011 and 2015.
 

While lung cancer has dropped sharply for men, it still accounts for the most deaths, killing 3,934 people in that five-year period. A total of 14,148 people were diagnosed with cancer in 2015, up from 11,758 in 2011.
 

But the report said that the rise in cancer cases is "generally not significant" once age is taken into account, since older people are at higher risk of cancer. It said: "As the risk of cancer increases with age, with an ageing population, the number of people being diagnosed and living with cancer is likely to continue to rise. However, as medical technology and cancer care improve, the number of cancer survivors will also increase.” 
 

Source: The Sunday Times © Singapore Press Holdings Limited. Permission required for reproduction

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