Understanding the Health Screening Awareness Gap in Singapore

A recent study has highlighted a critical issue in Singapore's public health landscape: approximately one in three residents who receive concerning health screening results fail to follow up with necessary actions. This awareness gap persists despite high screening participation rates, underscoring the need for better education and behavioral interventions. As Singapore's universities, including the National University of Singapore (NUS) Yong Loo Lin School of Medicine and Nanyang Technological University (NTU) Lee Kong Chian School of Medicine, lead research into preventive health strategies, their findings offer valuable insights into why this happens and how to address it.

The Screen for Life (SFL) program, launched by the Ministry of Health (MOH), has successfully boosted screening uptake to 66.4% for chronic diseases in 2024, returning to pre-COVID levels. However, the gap in follow-up reveals a disconnect between detection and action, potentially leading to preventable complications from conditions like diabetes, hypertension, and hyperlipidaemia—affecting about one in three residents aged 18-74.

Singapore universities are at the forefront, with NUS's Multi-Ethnic Cohort (MEC) and HELIOS studies providing data on lifestyle factors influencing screening behaviors. These academic efforts emphasize personalized approaches under the Healthier SG initiative, where enrolled citizens receive subsidized screenings and follow-ups at general practitioner clinics.

Key Findings from Recent National Surveys and Studies

The National Population Health Survey (NPHS) 2024, conducted by MOH, reports stable chronic disease prevalence: diabetes at 9.1%, hypertension at 33.8%, and hyperlipidaemia at 30.5%. Cancer screening rates show modest gains—breast at 35.2%, colorectal and cervical at 44.9% each—but remain below targets. The MORROW Medical study, featured in CNA discussions with Dr. Ari Ali Sahebkashaf, pinpoints that 33% ignore abnormal results, often due to denial or lack of understanding.

• 49% of residents underwent standard checkups in the past year (2024 survey).
• Follow-up rates for abnormal cardiovascular screenings improved to over 60% under SFL, but gaps persist in private screenings.
• Younger adults (18-39) show lower uptake, per NTU research on Healthier SG enrollment effects at age 40.

Duke-NUS Medical School's population health research highlights how socioeconomic factors exacerbate disparities, with lower-income groups less likely to act on results despite subsidies.

Why Do Singaporeans Ignore Concerning Results? Insights from University Research

University studies reveal multifaceted reasons. NUS Yong Loo Lin School of Medicine's Public Health Service (PHS) program, run by students, identifies fear of diagnosis (25% cite this), complacency ('I'm healthy'), and confusion over results interpretation as top barriers.

NTU LKCMedicine's multi-country cancer screening study notes an 'intention-action gap': 80% intend to screen but only 45% follow through, linked to busy lifestyles and low perceived risk. SMU's Research on Singaporean Ageing and Care (ROSA) found older adults (53+) support Healthier SG but lag in lifestyle changes post-screening due to limited family doctor consultations—two in three lack a regular GP.

Ethnic differences emerge: Malays and Indians show 10-15% lower follow-up than Chinese, per MEC3 cohort at NUS.

Demographic Disparities: Who Is Most Affected?

The 'silent gap' in cardiometabolic screening, documented in Annals of the Academy of Medicine Singapore, shows geographic and socioeconomic divides. Residents in mature estates have 20% higher uptake than new towns.

• Men: Lower participation (55% vs 70% women).
• Young professionals: Ignore due to optimism bias.
• Seniors: Physical access issues, per Duke-NUS studies.

NUS's BREATHE cohort pilots risk-based breast screening, revealing higher-risk women (family history) often delay follow-ups.

Photo by Sasun Bughdaryan on Unsplash

Health Impacts: The Cost of Inaction

Ignoring results contributes to late-stage detections. Colorectal cancer screening lag leads to 20% preventable deaths, per MOH. Chronic conditions unmanaged raise healthcare costs by S$2 billion annually. University models from NTU predict 15% diabetes rise by 2030 without better follow-up.

Duke-NUS research links poor follow-up to rising obesity (now 12%), straining Healthier SG's preventive focus.

Government Initiatives: Screen for Life and Healthier SG

SFL offers subsidized screenings (S$5 or less), with 40% abnormal cardiovascular results seeing improved follow-ups. Healthier SG mandates GP enrollment for personalized plans, boosting age-40 uptake per regression studies.

Universities support via student-led screenings: NUS PHS screened 5,000 Jurong residents in 2025, educating on follow-ups.

University-Led Innovations and Expert Perspectives

NUS HELIOS study explores longevity medicine awareness, finding 40% unaware of healthspan vs lifespan. NTU's AI tools predict non-compliance risks. Duke-NUS Programme in Health Services & Population Health develops digital nudges for reminders.

"Targeted education from universities can bridge this gap," says Prof. Tan Hak Koon, NUS Medicine Dean.

SMU's lifestyle tool validates behaviors post-screening, aiding interventions.

Real-World Case Studies and Lessons Learned

A 45-year-old IT executive ignored high cholesterol (from private screen), leading to a mild stroke two years later—now advocates follow-ups via NTU alumni networks. NUS case studies show community workshops double action rates.

In Healthier SG pilots, GP reminders increased compliance by 25%.

Photo by Sasun Bughdaryan on Unsplash

Actionable Solutions: Bridging the Gap

• Digital apps for result interpretation (Duke-NUS pilots).
• University-GP partnerships for counseling.
• Targeted campaigns for youth/men via social media.
• AI risk predictors from NTU for personalized nudges.

Listen to CNA discussion on the study.

Future Outlook: Universities Driving Change

With Screening Test Review Committee 2026 updating guidelines, university research will refine risk-stratified screening. Projections: 80% uptake by 2030 if gaps close. Singapore's academic institutions position the nation as a preventive health leader.