One in four women who had free mammograms last year failed to return for follow-up tests, despite their scans indicating possible abnormalities.
The women had gone for screening under the Breast Cancer Foundation Encouragement for Active Mammograms (Beam15) programme, launched in March last year.
Beam15 targets low-income women aged 50 and above. The initiative - a collaboration with the Health Promotion Board (HPB) - screened about 8,700 women last year. Of this group, 1,200 had screening results which required further assessment. But about 300 never came back.
These numbers are "worrying" because they suggest women do not fully understand the point of screening, said Dr Esther Chuwa, a consultant breast surgeon at Gleneagles Hospital.
For Singaporean women, breast cancer is the most common type of cancer. It is also the top cause of cancer death. About 1,600 women were diagnosed with breast cancer each year between 2008 and 2012. During the same period, nearly 400 died from it every year.
"A lot of women get stuck at the stage where they don't go back for follow-ups because they're afraid they cannot afford treatment," said Dr Chuwa. "But treatment at an early stage is less complicated, and will end up in more cost savings."
In fact, nine in 10 who return for further tests are likely to find out they do not have cancer at all.
HPB said only 53 of the 890 who returned for follow-ups under Beam15 were eventually diagnosed with cancer.
The cost of additional tests was a major reason why many women under the Beam15 programme did not return, said Dr Shyamala Thilagaratnam, director of the preventive health programmes division at HPB.
"HPB nurse educators conduct one-on-one phone counselling with the participants to encourage them to go for follow-ups and explain the financial schemes available," Dr Shyamala said.
Another common reason was lack of time. Typically, additional tests include a repeat mammogram, a breast ultrasound or a biopsy to extract breast tissue for examination.
Breast Cancer Foundation president Noor Quek suggested getting women in the same peer group to tell others about the importance of screening. "It helps them overcome the fear of the unknown... and that gives them encouragement."