CANCER DETECTION AND TREATMENT (Expansion of facilities)

Madam Chan Choy Siong asked the Minister for Health, in view of the prevalence of cancer of the womb and breasts among women, whether he will consider expanding the facilities for cancer detection and treatment, and if he will introduce legislation to provide for periodic examinations for cancer.

Mr Chua Sian Chin: Mr Speaker, Sir, for the information of the Member for Delta, the figures for cancers of the breast and uterus occurring in Singapore are as follows: Year Breast Neck of Body of uterus uterus 1965 92 112 43 1966 112 121 49 1967 106 136 27 1968 103 95 27

In terms of percentages, cancers of the breast account for 12 per cent, cancers of the neck of the uterus 22 per cent, and body of the uterus 4 per cent of all types of cancer affecting women in Singapore. Compared with the average figures over the previous five years from 1960 to 1964, there has been no significant increase, although there is an apparent increase when compared with the figures for the years 1950 to 1959. This really is due to better service and more comprehensive diagnostic methods of detecting cancer rather than any true upward trend.

Mr Speaker, Sir, since my last statement in this House in December 1968 on a similar subject, although the Cytological Service in our Kandang Kerbau Hospital has not had the number of its staff increased, the number of slides examined by it has increased. There is provision for nine Cytotechnicians but only eight are presently employed, one having resigned. The number of slides, with corresponding suspicious and confirmed cases of cancer, is as follows: Year Total No, of No, of Slides Suspicious confirmed examined slides cases 1966 1,744 71 42 1967 9,779 142 71 1968 14,677 166 116 1969 14,883 126 67 (Jan to Nov)

Slides examined in our Kandang Kerbau Hospital come from two sources - hospital patients and from selected Maternal and Child Health Clinics. As the majority of slides from hospital patients come from cases which have symptoms, the yield of suspicious and confirmed cases is higher. On the other hand, a considerable number of slides from Maternal and Child Health Clinics are from patients without symptoms. In the Maternal and Child Health Clinics, the yield is approximately three out of 1,000 slides examined. This figure is similar to the findings in many other centres throughout the world.

Prior to October 1969, not all gynaecological cases seen at the Kandang Kerbau Hospital are routinely examined with a cytological smear. However, since that date, all gynaecological cases attending the hospital are now being screened.

In the case of cancer of the breast, detection can only be made when patients come forward because of a complaint of a lump in the breast. It would be extremely difficult to provide a routine examination for all women. However, women who detect any small lump in the breast should see their general practitioners or attend one of the Government outpatient dispensaries, or one of the Maternal and Child Health Clinics. They will be referred to the surgeon if the doctor feels this requires further opinion.

It is not intended to introduce legislation to provide for periodic examinations for cancer.

A proposal for the expansion of the Cytological Service has been made this year. This has been submitted to Treasury for consideration. It is intended under this proposal to screen all women who are likely to have symptoms. The estimated figure to require such screening will be about 100,000 to 125,000 cases per year.