What actually changed

The Screening Test Review Committee advises the Ministry of Health on which screening tests are worth doing, for whom, and how often. Its 2026 report was published in February, and it is the first revision since 2019 — seven years in which both the evidence and Singapore's disease patterns moved on.

Volume 1 covers screening for breast, cervical, colorectal and lung cancer, along with diabetes, high cholesterol, high blood pressure, obesity and osteoporosis. Four changes matter most to most people.

Breast cancer screening now starts at 40

• Now: a mammogram every year from 40 to 49, then every two years from 50 to 74, for women without symptoms and at normal risk.
• Before: every two years from 50 to 69 only.

That is a decade earlier at the start and five years longer at the end. The reasoning is that breast cancers in younger women tend to be more aggressive, so finding them earlier matters more. Screening yearly rather than every two years in your forties reflects the same thinking — and denser breast tissue in younger women makes cancers harder to spot, so the interval is shorter.

If you are in your forties and have never had a mammogram because you believed screening started at 50, this is the change most likely to affect you.

Osteoporosis screening is new

• Now: risk assessment for women from 50 and men from 65, with a bone mineral density scan for those found to be at higher risk, and roughly five-yearly intervals.
• Before: no screening recommendation for the general population at all.

This is the most significant addition, because osteoporosis is silent until something breaks. Bone thins without symptoms, and the first sign is often a fracture from a fall that should not have caused one — a wrist, a hip, or a vertebra. A hip fracture in an older adult is a serious event with lasting consequences for independence.

Note the two-step design: most people get a risk assessment, not a scan. The scan follows if the assessment suggests it is warranted.

Blood pressure: now yearly, even if it is normal

• Now: at least once a year, including for people whose readings have always been normal.
• Before: once every two years.

High blood pressure has become more common across most age groups, and it produces no symptoms until it has already done damage. Halving the interval is a small change that is easy to act on: a blood pressure check takes a minute and can be done at any consultation, for any reason.

Lung cancer screening covers a wider age range

• Now: for people at high risk, from 50 rather than 55, and up to 80 rather than 74.

This applies to people at high risk — principally a significant smoking history — rather than to everyone. If you smoke or used to, it is worth asking whether it applies to you, because the age band that qualifies has widened at both ends.

Why the guidelines point you to your GP, not a screening fair

This part is easy to miss, and it is the most useful thing in the report for deciding how to act on any of the above.

The Ministry of Health states that screening is most effective in a primary care setting, where a doctor can give advice tailored to you, explain what a result actually means, and make sure any follow-up happens. It goes further, and advises against taking part in mass screening events that may not provide individual assessment or proper follow-through — recommending you see your primary care doctor instead, who can weigh your own risk profile.

The logic is not hard to see. A screening test that produces a result nobody explains, and a positive finding nobody follows up, has not achieved anything. It may have made things worse, if it produced false reassurance.

Screening is not one list for everybody

The recommendations sort tests into three groups, and knowing which is which explains a lot of the confusion around health screening packages.

• Beneficial for everyone. Strong evidence, worth doing at a population level. These are the ones in national programmes such as Healthier SG Screening.
• Beneficial for some. Worthwhile depending on your risk factors — family history, existing conditions, exposures. These are a decision to make with your doctor, not a box to tick.
• Not recommended. Either the evidence is insufficient, or the harms outweigh the benefits. Some tests sold in commercial packages sit here.

This is why a longer list of tests is not automatically a better check-up. More tests mean more incidental findings, more anxiety and more follow-up investigations, some of which carry their own risks.

What to do about it

• If you are a woman in your forties — ask about mammography. The starting age moved, and this is the change most people have not heard about.
• If you are a woman over 50, or a man over 65 — ask about osteoporosis risk assessment. It is new, so nobody will have offered it to you before.
• If your blood pressure was fine two years ago — it is due again now, not next year.
• If you smoke or used to — ask whether lung cancer screening applies to you.
• If you are over 40 generally — diabetes and cholesterol screening remain part of the picture, and Healthier SG subsidies may apply.

How Bethesda Medical can help

Our family physicians go through what you are actually due for, based on your age, sex, family history and existing conditions — rather than a fixed package. We arrange the tests that apply, explain the results, and follow up on anything that needs it. Where a referral is needed, for a mammogram or a bone density scan, we organise it and the results come back to us.

Many of these screenings are subsidised under Healthier SG for eligible patients. We will tell you what applies to you before anything is booked.

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Where things stand

As of 24 August 2026, the National Environment Agency reports hotspots and dense smoke plumes over Kalimantan and southern Sumatra, with some over Riau. Dry conditions are expected to persist through the week, and with winds blowing from the south or south-east, Singapore can expect occasional periods of haze.

The readings that afternoon: the 24-hour PSI stayed within the moderate band, highest in the central region at 91. The 1-hour PM2.5 was normal across most of the island, but elevated in the central region at 65. Two weeks earlier, on 9 August, the central PSI had been 81 — so the direction of travel has been upward rather than settling.

The source is not in doubt. Indonesia's disaster agency recorded roughly 1,250 hotspots in the week to 21 August, more than 900 of them in Kalimantan alone, and has made tackling those fires a priority.

None of this is a surprise. The Government's Haze Task Force — 28 public agencies chaired by NEA — met twice during 2026 before the season even began. In June, the Singapore Institute of International Affairs issued a rare red alert in its annual Haze Outlook, with risk expected to peak across August and September.

Readings change hour by hour, so treat the numbers above as a snapshot rather than a forecast. NEA publishes live 24-hour PSI, 1-hour PM2.5 and air quality forecasts on its haze portal.

What the numbers next door tell us

If you want to know what haze does to a population, look at Malaysia, where the air has been worse for longer. Malaysia's Ministry of Health tracks haze-related illness through sentinel clinics, and the figures it reported on 23 August 2026 are stark.

Between epidemiological weeks 32 and 33 — roughly 9 to 22 August — asthma cases picked up by those clinics rose from 61 to 219. Upper respiratory tract infections rose from 1,637 to 3,674. Conjunctivitis, interestingly, fell slightly.

The timing is the part worth noting. Only a week earlier, on 15 August, the same ministry had reported no significant rise in haze-related illness. The jump came suddenly, once exposure had accumulated. That is the pattern haze tends to follow: nothing, nothing, nothing, then a wave of people who cannot breathe properly.

The scale is worth registering too. On 23 August, Malaysia's Air Pollutant Index Management System — which publishes hourly readings from 68 monitoring stations nationwide — had seven areas sitting in the unhealthy band and 61 more in the moderate band. Not one station recorded good air. This is a regional event, not a local one.

A note on the numbers, since both countries are in the news: Malaysia reports an API and Singapore reports a PSI. They are different indices and are not directly comparable, though the bands are read the same way — above 100 is unhealthy in both.

What haze actually does to your body

Haze is not simply smoke you can see. The pollutant that matters most is PM2.5 — particles small enough to travel past the nose and throat and reach deep into the lungs. Bigger particles get filtered out on the way in. These do not.

Once there, they irritate and inflame the airway lining. In a healthy person that usually produces the familiar nuisances: itchy eyes, a dry or sore throat, a blocked or runny nose, a cough that will not settle. Singapore's Ministry of Health puts it plainly — for healthy people, short-term exposure over a few days generally causes irritation of the eyes, nose and throat rather than anything more serious.

The problem is that airways which are already inflamed react differently. If you have asthma, the same particles can tip a well-controlled condition into an attack. If you have chronic lung disease, they can trigger a flare-up. And the strain is not only respiratory — fine particulate matter places extra load on the heart, which is why people with heart conditions are advised to be careful too.

Reading the PSI without overthinking it

The 24-hour PSI is the number the health advisories are built around. NEA publishes it, along with 1-hour PM2.5 readings and forecasts, on its haze portal.

• 0–50, Good — no precautions needed.
• 51–100, Moderate — fine for most people. If you have asthma or lung disease, this is the point to check your medication is on hand.
• 101–200, Unhealthy — NEA begins issuing daily advisories with next-day forecasts. Reduce outdoor exertion; if you have chronic heart or lung disease, avoid it.
• 201–300, Very unhealthy — minimise time outdoors.
• Above 300, Hazardous — stay indoors.

One caveat worth knowing: the 24-hour PSI is an average, so it lags behind what you are breathing right now. If the air looks and smells noticeably worse than the number suggests, the 1-hour PM2.5 reading is the more responsive figure.

PM2.5 has its own bands, and they carry their own advice. When it reaches the elevated range — as it did in the central region on 24 August — NEA's guidance is to consider easing off strenuous outdoor activity for the next hour. Vulnerable people, meaning the elderly, pregnant women, children and anyone with chronic lung or heart disease, should avoid strenuous outdoor activity at that point rather than merely reduce it.

Who needs to be more careful

Health advisories single out particular groups, and the distinction is not arbitrary — it reflects who actually turns up unwell.

• People with asthma — the group the Malaysian figures show being hit first and hardest.
• People with chronic lung disease, including COPD and bronchiectasis.
• People with heart disease — fine particles add cardiovascular strain, not just respiratory.
• Children — smaller airways, faster breathing, and more time spent running around outdoors.
• Older adults, particularly anyone with an existing heart or lung condition.
• Pregnant women — advised to minimise prolonged or strenuous outdoor exertion.

Everyone else is not immune, simply better buffered. Healthy people who exercise hard outdoors during haze can still end up with a cough that lingers well after the sky clears.

What you can do at home

• Cut outdoor exertion. Exercise makes you breathe harder and deeper, drawing more particles further in. Move the run indoors, or leave it for a clearer day.
• Drink water. NEA's standard advice, and it genuinely helps a dry, irritated throat.
• Keep windows shut when the air is bad, and run air-conditioning or a purifier if you have one.
• Use an N95 mask if you must be outdoors for long in unhealthy air. A surgical or cloth mask does not filter PM2.5.
• If you have asthma, check your inhalers now — before you need them. Confirm the reliever is not empty or expired, and keep taking your preventer even on days you feel well.

When to see a doctor

Most haze symptoms settle once the air clears. These do not fall into that category, and are worth a consultation rather than a wait.

• Wheezing, chest tightness or breathlessness — particularly if you have asthma and your reliever is not lasting as long as usual, or you are reaching for it more often.
• A cough that has not settled after the air has improved, or one bringing up discoloured phlegm.
• Fever alongside respiratory symptoms — that suggests infection rather than irritation, and infection needs treating.
• Eye symptoms that persist despite staying indoors, or eyes that become genuinely painful rather than merely gritty.
• Any chest pain, or breathlessness at rest.
• A child who is breathing fast, wheezing, feeding poorly or unusually drowsy.

Health advisories are consistent on this point: people who are unwell during haze — especially the elderly, children, and anyone with chronic heart or lung conditions — should seek medical attention rather than wait it out.

If you are struggling to breathe, cannot speak in full sentences, or your lips or fingertips look blue, that is an emergency. Call 995 or go to the nearest emergency department.

How Bethesda Medical can help

Our family physicians see the whole range of haze-related illness, from an irritated throat that needs reassurance to an asthma flare that needs treating properly. In a consultation we can:

• Assess your breathing and work out whether this is irritation, an asthma flare, or an infection that has taken hold.
• Treat an asthma or COPD flare-up, including nebulisation where it is needed.
• Review and adjust your inhalers — haze season is exactly when a preventer that has been quietly under-dosed shows itself.
• Treat respiratory infections, eye irritation and the sinus symptoms that often follow.
• Write an asthma action plan so you know what to do next time the PSI climbs, without having to guess.
• Refer you on if your symptoms point to something that needs specialist assessment.

You do not need to wait for things to get bad. If you have asthma or a chronic lung condition and the forecast is poor, a review before the air worsens is far easier than a flare-up in the middle of it.

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The numbers, plainly

The latest Singapore Cancer Registry annual report counted 4,995 cancer diagnoses in people under 40 for the period 2019–2023. Two decades earlier, in 2003–2007, the figure was 3,729 — a rise of about 34 per cent. Go back to the earliest years on record, 1968–1972, and it was 1,710.

Specialists at Singapore’s cancer centres have noted that while cancer remains far more common in older adults, the fastest rises in age-specific incidence are in people under 50 — sharpest of all among men in their thirties and women in their forties. This mirrors what cancer registries in many developed countries are reporting: early-onset cancer, particularly of the digestive system, is becoming steadily more common with each generation.

Why is this happening?

Researchers describe a “birth cohort effect”: each generation born after the 1950s appears to carry a somewhat higher cancer risk than the one before it. One widely cited illustration from colorectal cancer research — a person born in 1990 is roughly four times more likely to develop colorectal cancer over their lifetime than someone born in 1950.

The honest answer to “why” is that no single cause has been proven. The leading explanation points to changes in what scientists call the early-life exposome — everything a generation is exposed to as it grows up. The suspects will sound familiar: diets heavier in ultra-processed food, rising obesity, more sedentary daily patterns, and shifts in the gut microbiome. These are associations under active research, not a settled verdict — but they are consistent across many countries, including here.

One thing specialists are clear about: this is not simply better detection finding cancers that would always have been found. If anything, the opposite problem applies to young adults — some early-onset cancers are picked up at more advanced stages, precisely because neither the patient nor, sometimes, the first doctor they see expects cancer in someone that age.

Why young adults get caught late

A persistent ache gets blamed on the gym. Fatigue gets blamed on work. A change in bowel habit gets blamed on stress or diet. In your twenties and thirties these explanations are usually right — which is exactly why the exceptions slip through. Being busy building a career or a young family also makes it easy to postpone the check-up “until things settle down”.

Young adults’ needs are genuinely different, too. A diagnosis at 30 raises questions an older patient may never face — fertility, early careers, young children, decades of survivorship ahead. All of that argues for the same thing: finding problems at the earliest, simplest stage, when treatment is shorter and options stay open.

The symptoms not to dismiss

Cancer specialists in Singapore advise that young adults should not ignore symptoms that are unusual for them and do not settle. See a doctor promptly about:

• Unexplained weight loss — losing weight without trying
• Persistent fatigue that rest doesn’t fix
• A lump or swelling anywhere — neck, breast, testicle, abdomen
• Pain that does not go away, or keeps returning in the same place
• A persistent change in bowel habit, or blood in the stool
• Unusual bleeding of any kind

None of these means cancer — each has far more common, benign explanations. The point is simpler: a symptom that persists for more than two to four weeks has earned a proper look, whatever your age. A GP consult is quick, and most of the time it will rule things out.

What screening can — and can’t — do before 50

It’s worth being precise here, because “go for screening” is often said loosely. Singapore’s national programmes screen for three cancers — breast, cervical and colorectal — and each has a starting age set by evidence:

• Cervical screening starts young — from age 25 for women who have ever had sex (a Pap test every three years at 25–29, then an HPV test every five years from 30). If you’re in your twenties or thirties, this one is already for you.
• Mammograms are recommended from 50, or from 40–49 after a discussion of the pros and cons.
• Colorectal screening (a simple yearly stool test, or colonoscopy) starts at 50 for average-risk adults — but earlier if your risk is higher.

That last clause matters more than it looks. A family history of colorectal, breast, ovarian or certain other cancers can move your screening timetable years earlier — and most people have never actually mapped theirs. Ask your parents. Then bring the answers to a doctor, who can turn them into a concrete plan: which tests, starting when. That conversation is precisely what a cancer screening consult is for.

And for everything population screening doesn’t yet cover at your age, the tools are the two above: know the symptoms, and act on them early.

What you can do this year

• Map your family history — cancers, who, and at what age. It changes screening advice more than any other single fact about you.
• Book the screening you’re already due for. Women from 25: cervical screening. From 40–49: talk through mammograms. From 50: all three programmes.
• Act on persistent symptoms — the two-to-four-week rule above.
• Shift the odds — more whole foods and fewer ultra-processed ones, regular movement, a healthy weight, less alcohol, no smoking. None of these is a guarantee; together they lean on the same risk factors researchers keep finding.

What's happening

Singapore recorded 11 measles cases in January 2026 alone — compared with just two in January 2025, and matching the total for the whole of 2024. A further twelve cases followed between February and late March. By 28 April 2026, 31 cases had been reported for the year.

That last figure is the one worth pausing on. Of the 31 cases, five were infants under 12 months — too young for their first MMR dose. Of the remaining 24 who were old enough to be vaccinated, just one was fully vaccinated. Two had received a single dose. The other twenty-one had no vaccination history, or none that could be established.

Why now?

Singapore's rise mirrors a global one. The World Health Organization reported around 11 million measles infections worldwide in 2024, exceeding pre-pandemic levels. In the Western Pacific region, confirmed cases climbed roughly five-fold in a single year.

At least seven countries — among them Canada and the United Kingdom — have lost their measles elimination status because the virus began circulating continuously again. Singapore achieved elimination status in 2018, and most of our cases are still linked to overseas travel. But with high travel volumes and pockets of unvaccinated people, imported cases keep arriving.

Who is most at risk?

• Infants under 12 months, who are not yet eligible for their first MMR dose
• Children who have missed or delayed their scheduled MMR doses
• Adults unsure of their vaccination history, or who never completed two doses
• People who are immunocompromised and cannot be vaccinated
• Travellers heading to countries with active outbreaks

Infants and immunocompromised people can't be protected directly. They depend on everyone around them being immune — what's known as herd immunity. Singapore's first-dose MMR coverage has consistently exceeded 95%, which is why a large outbreak remains unlikely. But that protection only holds if it's maintained.

How contagious is measles, really?

Extremely. Measles is one of the most transmissible diseases known. It spreads through the air and through contact with nasal and throat secretions, and an infected person is contagious from about four days before the rash appears until four days after — meaning they spread it before they know they have it.

It is also not a trivial illness. Measles can cause pneumonia and encephalitis (inflammation of the brain), and complications are most common in children under five.

Symptoms to watch for

• High fever, cough, runny nose and red, irritated eyes
• A blotchy rash, typically starting on the face and spreading downwards
• Small white spots inside the mouth, in some cases

If you or your child develops these symptoms — particularly after overseas travel, or after contact with a case — call the clinic before coming in. Because measles spreads through the air, letting us know in advance allows us to see you safely without exposing others in the waiting room.

What the authorities have changed

From 1 April 2026, the Communicable Diseases Agency (CDA) made its stepped-up measures the new baseline. In practice, that means:

• Mandatory testing of all suspected measles cases
• Mandatory isolation of confirmed cases until they are no longer infectious
• Post-exposure prophylaxis offered to susceptible close contacts, rather than quarantine
• Additional restrictions for those working or studying in high-risk settings, such as childcare centres and healthcare facilities

What you should do

The response is simple, and it hasn't changed: make sure you and your family have had two doses of the MMR vaccine.

For children

Under the National Childhood Immunisation Schedule, MMR is given at 12 months and again at 15 months. Measles vaccination is compulsory for children under 12 living in Singapore under the Infectious Diseases Act. If your child has missed a dose, catch-up vaccination is straightforward — just book an appointment.

For adults

If you were never vaccinated, or have no evidence of past infection or immunity, the National Adult Immunisation Schedule recommends two MMR doses at least four weeks apart. If you simply don't know, that's very common, and easily resolved: a blood test can check your immunity, or we can vaccinate you.

Before you travel

If you're heading somewhere with measles circulating, confirm your immunity four to six weeks before departure — enough time to complete vaccination if you need it.

Where to get the MMR vaccine

The MMR vaccine is available at our clinics, as well as at polyclinics and other GP clinics. Eligible Singapore Citizens receive subsidies at CHAS GP clinics, and MediSave can be used at MediSave-accredited clinics. It's safe, highly effective, and confers long-term immunity after two doses.

You can read more on our MMR vaccine page, or see the full range on our vaccinations page.