Forum: Insurance policies must evolve with rising cancer diagnoses among younger people

I read with concern the article, “More young adults, teens in Singapore being diagnosed with cancer” (Jan 26).

I am a Singaporean in my 20s undergoing treatment for triple negative breast cancer, one of the most aggressive forms of the disease. I carry the BRCA1 gene mutation, which significantly increases my lifetime risk of developing breast and ovarian cancer, as well as the risk of recurrence.

Given this risk profile, my medical team advised a bilateral mastectomy with reconstruction, one side to treat the existing cancer, the other to reduce the likelihood of a second malignancy.

International clinical guidelines support this recommendation and it is widely accepted as standard care for high-risk patients.

However, I was devastated to learn that insurance would only cover the surgery fully on the cancerous side. The prophylactic surgery and reconstruction on the other breast was deemed “preventive” and only partially covered under MediShield Life and Income Insurance. 

This is despite the entire procedure being medically recommended. 

This meant bearing a substantial cost out of pocket at a time when I was already physically, emotionally and financially strained.

The rise in early-onset cancers brings up an important question: Are our health financing frameworks keeping pace with changing disease patterns?

Cancer is no longer confined to older age groups. Younger patients often face more aggressive cancers, inherited genetic risks and longer survivorship horizons, all of which make prevention a medical necessity rather than a lifestyle choice.

Preventive surgery for genetically high-risk patients is also cost-effective in the long run. Treating a second, potentially more advanced cancer places a greater strain on both patients and the healthcare system than preventing it in the first place.

The Ministry of Health has said it will review MediShield Life’s coverage for prophylactic mastectomy.

This review is timely and necessary. As cancer diagnoses among young Singaporeans rise, policies must evolve to reflect medical evidence and patient realities.

Gwendalyn Too