Making Mammograms More Accessible in Singapore

How Singapore’s Community Mammobus successfully doubled the number of first-time goers and increased the number of women who went for breast screening by 68% In Singapore, the battle against breast cancer starts with awareness. According to the Singapore Cancer Registry, breast cancer is the most common cancer among Singaporean women. However, less than 40% of eligible women adhere to their annual mammogram screenings[1]. On top of this, the incidence of breast cancer has more than doubled over the last 40 years[2], with about 1,930 newly diagnosed cases and about 420 deaths every year. As the disease shows no signs of slowing down, Singapore health ministries and societies have banded together to take a serious stand. “Breast cancer has a far-reaching negative impact on society. When a woman is diagnosed with breast cancer, everyone around her – including her family, friends, employers and colleagues are affected. Yet, the survival rate of breast cancer in earlier stages such as stage 1 is 90% compared to 21% for those diagnosed at stage 4. Based on the current statistics in Singapore, a lot more needs to be done to create a call to action,” says Ms. Kong Kum Yin, Head of Business Development, National Healthcare Group Diagnostics (NHGD). NHGD is the leading provider in primary healthcare for one-stop imaging and laboratory services. They partner with community advisors, and voluntary welfare organizations to improve access to integrated healthcare services in Singapore. In 2018, NHGD alongside the Singapore Breast Cancer Foundation (BCF) and Singapore Cancer Society (SCS) launched the Community Mammobus Programme to enable easier access to affordable mammogram screening. Under this Program, 40-year-old women who are getting their first mammogram can get the exam for free, while those who have been screened before pay between seven and 26 dollars. In its first year, the program successfully doubled the number of first-time goers and increased the number of women who went for breast screening by 68%. Ms. Anne Bibbings, a 47-year old teacher at an international school, and a second-time patron of NHGD’s mammobus, believes that this is a step in the right direction to improve access and awareness of breast screening in Singapore. “The waiting time is minimal, the staff on the bus are lovely… The mobile mammobus couldn’t make it any easier for a woman to get a scan,” she said. “With all the high-profile celebrities who have suffered with breast cancer, it has definitely raised the awareness to more people and when something like the mammobus makes the process of getting it done so easy, it is great for all of us who are busy juggling work and home life.” Since 2018, NHGD has been working with GE Healthcare on a new mammobus that brings digital mammography technology to the masses, without compromising the affordability and accessibility factors, which were key reasons for the program’s success. To drive accessibility in housing development estates, which houses 70% of Singaporeans, the new bus is shorter to navigate narrow roads and host events in the community. “Many women in Singapore also cite time constraints and the fear of pain during the mammogram as deterrents for a routine scan. The misconception of pain is also something we want to address with the technology, which was designed with patient comfort in mind,” added Ms Kong. This mammography system, called Senographe Pristina™ features an element of patient comfort, including rounded corners, a thinner image detector, and comfortable armrests for women to lean on instead of conventional handgrips so women can relax their muscles during the exam, which simplifies positioning, compression and image acquisition. “Such screenings support the Ministry of Health’s objective of placing more emphasis on health instead of healthcare. We are very encouraged by the support from organizations and the community, which has led to a 40% increase in screening events organized for their workforce, residents, and tenants over the past year. With the new bus, we are targeting a similar increase this year,” said Ms Kong. “It is our hope that if we can improve the accessibility and patient experience, perhaps we can reduce the number of skipped mammogram screenings and increase the chances of catching cancer earlier,” said Ms Kong.   [1] Singapore Health Promotion Board [2] Singapore National Registry of Disease Office