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.