The Rise of RISE: A New Era in Cancer Research at NTU

Established in September 2025 through a collaboration between NTU's Lee Kong Chian School of Medicine (LKCMedicine) and the National Cancer Centre Singapore (NCCS), RISE represents Asia's first dedicated institute for clinical translational research in cancer prevention and early detection. Funded initially by a S$2.5 million donation to the NCCS Cancer Fund and an additional S$1 million from LKCMedicine, RISE bridges the gap between cutting-edge science and public health policy.

Co-directed by Professor Ravindran Kanesvaran from NCCS and Professor Jon Emery from LKCMedicine, the institute leverages Singapore's integrated healthcare system. It partners with public healthcare clusters like SingHealth and the National Healthcare Group (NHG), emphasizing primary care's role from prevention to survivorship. RISE's mission is to generate robust, Asia-specific evidence, as most global trials focus on Western demographics where cancer biology and risk factors differ significantly.

In Singapore, where lifestyle-related cancers are surging—linked to metabolic dysfunctions like diabetes and obesity—RISE positions NTU as a leader in proactive health strategies aligned with the Healthier SG initiative.

Decoding MCED: Multi-Cancer Early Detection Tests Explained

Multi-Cancer Early Detection (MCED) tests mark a paradigm shift in screening. These liquid biopsies analyze a simple blood sample for tumor-derived DNA fragments and proteins, potentially identifying signals from over 50 cancer types simultaneously. Unlike traditional single-cancer screens such as mammograms or colonoscopies, MCED offers convenience, reducing barriers like invasiveness and discomfort.

The process begins with a blood draw, where genomic alterations and methylation patterns in circulating tumor DNA (ctDNA) are detected using next-generation sequencing or machine learning algorithms. Advanced tests even predict the cancer's tissue of origin, guiding follow-up diagnostics. Sensitivity for stage I-II cancers hovers around 50-90 percent in trials, with low false positives (under 1 percent), making them promising for high-risk groups.

However, challenges persist: early-stage tumors shed minimal ctDNA, costs range from S$1,000 to S$5,000 per test, and long-term outcomes in diverse populations remain unproven. Globally, companies like Grail and Exact Sciences lead MCED development, but Asian validation is scarce.

NTU and NCCS's MCED clinical trial, launching in the second half of 2026, will recruit 1,000 high-risk individuals—those with pre-malignant conditions or hereditary syndromes like Lynch syndrome. Participants will be monitored for five years via Singapore's national health database, evaluating detection rates, survival impacts, and integration feasibility into national programs. Professor Kanesvaran emphasizes, “MCED tests hold promise, but rigorous evidence is essential for our population.”

CRAnE Study: Personalized Risk Assessment for Metabolic Cancers

The Cancer Risk Assessments and Early Detection (CRAnE) study targets Singapore's growing metabolic crisis. Conditions like diabetes (prevalent in 11.6 percent of adults), obesity, hypertension, and dyslipidemia elevate risks for liver, colorectal, pancreatic, endometrial, breast, esophageal, and lung cancers—often diagnosed late, contributing to high mortality.

Led by LKCMedicine, CRAnE integrates polygenic risk scores (PRS)—genomic analyses summing thousands of variants to predict susceptibility—with lifestyle data and biomarkers. In primary care settings (NHG polyclinics and private GPs), 200 participants with metabolic risks will receive tailored reports recommending specific screens or interventions, like enhanced colorectal checks for high-risk profiles.

The initial feasibility phase starts H2 2026, paving the way for a larger randomized controlled trial assessing cost-effectiveness. Professor Emery notes, “By empowering primary care, CRAnE can shift from reactive treatment to proactive prevention, improving outcomes for Singaporeans.”

Photo by National Cancer Institute on Unsplash

Why These Studies Matter for Singapore's Cancer Landscape

Singapore faces unique challenges: a rapidly aging population (one in four over 65 by 2030), rising metabolic diseases (diabetes up 20 percent in a decade), and suboptimal screening (far below 70 percent benchmarks needed for mortality reduction). WHO data shows 40 percent of cancers preventable, yet local uptake lags due to awareness gaps, access issues, and cultural factors.

Singapore Cancer Registry reports highlight young adult surges (34 percent increase in under-50s), underscoring prevention's urgency. RISE studies promise data-driven policies, potentially incorporating MCED into Screen for Life and boosting participation via personalized nudges.

• Reduced advanced-stage diagnoses: Early detection triples survival rates.
• Cost savings: Treating early-stage cancer is 50-80 percent cheaper.
• Equity: Tailored approaches address disparities in ethnic groups (e.g., higher liver cancer in Chinese Singaporeans).

Expert Insights: Voices from NTU and NCCS Leaders

Professor Ravindran Kanesvaran, RISE Co-Director, stresses evidence needs: “We must understand MCED performance in Asians, follow-up pathways, and patient experiences to reduce advanced disease burden.”

Professor Jon Emery adds, “RISE uniquely positions primary care centrally, fostering integrated care from prevention to survivorship—vital for Singapore's model.” Their vision: Asia's hub for translational research, influencing policy regionally.

Collaborations Powering Innovation at NTU

RISE unites NTU's research prowess with NCCS's clinical expertise, NHG's primary care network, and national databases. This ecosystem enables real-world trials, unlike siloed global efforts. Future expansions include AI integration for risk prediction and behavioral interventions to boost screening.

Funding from philanthropists like Mr Prajna Murdaya underscores community support, aligning with Singapore's precision medicine push via initiatives like the National Precision Medicine program.

Challenges Ahead: From Promise to Practice

While exciting, hurdles remain: ethical PRS use (genetic privacy), equitable access (subsidies needed), false positives' anxiety, and validation in multi-ethnic Singapore. Global MCED trials like PATHFINDER show promise (1.4 percent positivity, 38 percent stage I-II detections), but Asian data lags.

RISE addresses these via rigorous design, diverse recruitment, and cost analyses—ensuring scalability.

Photo by National Cancer Institute on Unsplash

Global Context and NTU's Leadership Role

Worldwide, MCED advances (Grail's Galleri detects 50+ cancers), but Asia's higher gastric/liver burdens demand localized evidence. NTU's studies fill this void, potentially influencing ASEAN policies. As LKCMedicine grows, RISE elevates Singapore's higher education in health sciences, attracting talent and fostering interdisciplinary PhDs in genomics and epidemiology.

Future Outlook: Transforming Singaporean Healthcare

By 2030, RISE aims for MCED/CRAnE integration into national screening, targeting 70 percent uptake. Long-term: AI-enhanced PRS, wearable biomarkers, and prevention trials. For NTU students and researchers, opportunities abound in clinical trials, data science, and policy—positioning the university as Asia's cancer innovation hub.

These breakthroughs not only promise lives saved but also economic benefits, with early detection averting billions in treatment costs.