Affordable Genetic Testing for Breast and Ovarian Cancer Launches

Overview of New Genetic Testing Program

Beginning December 1, 2023, genetic testing for hereditary breast and ovarian cancer (HBOC) will be available at the National Cancer Centre Singapore, the National University Cancer Institute Singapore, and Tan Tock Seng Hospital. This initiative aims to provide subsidized access to crucial tests that can facilitate early detection and intervention for at-risk individuals.

Government Initiative

This program is part of a broader effort by the Ministry of Health (MOH), which previously announced in March its commitment to cover the costs of HBOC genetic testing and related interventions from December onwards. As of November 5, the MOH confirmed that eligible citizens and permanent residents can use means-tested subsidies to receive up to 70% off the cost of the testing.

Cost and Coverage

The full expense of the genetic test is approximately $1,000, but many patients may not need to pay out of pocket. Those with sufficient MediSave balances can cover the remaining costs. Furthermore, additional support is provided for seniors from the Pioneer and Merdeka Generation.

It’s important to note that the test is not gender-specific and is available to anyone who meets the eligibility criteria. These criteria include:

• Patients with breast and/or ovarian cancer who have HBOC risk factors.
• First-degree relatives of individuals known to carry the HBOC gene variant.
• Individuals with a strong family history of HBOC when their cancer-affected relatives are unavailable for testing.

Understanding HBOC

Approximately 1 in 150 Singaporeans has a gene mutation associated with HBOC. Women carrying these mutations have a significantly increased lifetime risk of developing breast and/or ovarian cancer, estimated to be five to ten times higher than the general female population. It’s also vital to understand that these mutations can affect both males and females.

Future Developments

The Ministry of Health has more plans to expand financial support for preventive measures in the coming years. Starting January 1, 2027, the MediSave Chronic and Preventive Care scheme will provide even greater financial support, building upon the existing MediSave500/700 limits. Until then, the current limits will apply to the HBOC genetic tests.

Seniors aged 60 and above can utilize their Flexi-MediSave accounts to help cover any remaining costs after subsidies.

Preventive Approaches and Support

In addition to genetic testing, the MOH will offer financial assistance for several preventive operations:

• Risk-reducing mastectomy: Covered by MediShield Life and MediSave, this surgery can lower breast cancer risk by at least 90%.
• Risk-reducing bilateral salpingo-oophorectomy: Scheduled to be covered by late 2026, this procedure can cut ovarian cancer risk by over 80%.

For ongoing monitoring, annual scans like MRIs and mammograms will be partially covered by MediSave, with limits of $600 per year and an additional $400 per year for seniors. Preventive drug therapies, if they are included in the Standard Drug List, will also receive subsidies.

The Cascade Testing Approach

Additionally, first-degree relatives of those who test positive for HBOC mutations are encouraged to pursue cascade testing, which is subsidized and can also be financed through MediSave.

It is estimated that around 2,000 people annually, including family members of HBOC gene variant carriers, stand to benefit from this subsidized testing initiative. By enhancing affordability and accessibility, the MOH aims to alleviate the impact of hereditary cancers, ultimately improving health outcomes and easing the burden on the healthcare system.

The Ministry remains committed to refining and expanding the range of healthcare measures available to the population, ensuring that more individuals can take proactive steps towards early detection and timely intervention in the future.