Education needed to get more to take up health screening

People aged 40 and above can soon get highly subsidised health screenings for at most $5 for up to five different tests. This new programme launched by the Health Ministry (MOH) could well be a game changer.

That is because the tests are for five conditions - diabetes, high blood pressure, high cholesterol level, cervical and colorectal cancers - which are common, serious and treatable.

If such conditions are discovered and treated early, the number of people who end up with serious complications could be significantly reduced. This, in turn, should lead to a drop in the number of people needing years of hospital and, perhaps, nursing home care for serious ailments.

It would also reduce the "disability years" of the average Singaporean - currently about a decade of ill-health. The life expectancy here is increasing by roughly three years every decade.

Unfortunately, for many, it also means longer years lived in poor health.

One big health issue here is that many people with chronic ailments are blithely unaware of them.

As a result, they do not take steps to treat the problem. Some discover their disease only when it has progressed and complications, such as kidney failure or a heart attack, land them in hospital.

Retired nurse Amy Goh taking Ms Alice Lau's blood pressure at the Diabetes Resource Centre in Yishun. People aged 40 and above can soon get affordable health screenings for conditions like diabetes and high blood pressure.  ST PHOTO: MARK CHEONG

The two cancers being tested are preventable if caught at the pre-cancerous stage. Yet, today, colon cancer remains the top cancer here, with about 2,000 people diagnosed each year and 750 dying of it. Early diagnosis could prevent much of this as it is usually a slow growing cancer.

Similarly, having uncontrolled diabetes, high blood pressure and cholesterol levels increase a person's risk of getting heart attack, heart failure and stroke.

Diabetes also increases the risk of getting kidney failure, going blind and needing gangrenous limbs amputated. Doctors here carry out about 1,500 amputations a year on diabetic patients.

The National Health Survey 2010 found that among people aged between 18 and 69, 11.3 per cent had diabetes, 17.4 per cent had high cholesterol levels and 23.5 per cent had hypertension.

Those figures, while high, are not as alarming as the finding that 51.4 per cent, or more than half the estimated 440,000 diabetics here, did not even know they had the medical problem.

Nor, for that matter, did 26.3 per cent of people with high blood pressure and 44.1 per cent with high cholesterol levels.

If all the sufferers of these chronic diseases knew about their conditions,some, hopefully the majority, would take steps to control or reverse their conditions.

In any case, they would get medical attention early. This should then reduce the number of people suffering from heart attacks, heart failure, stroke, kidney failure, blindness and gangrene requiring amputation.

However, not all diabetics are able to keep the disease under control. In Singapore, one in three known diabetics is not able to keep blood sugar at optimal levels, according to the MOH.

This could be due, in part, to discovering the problem late when the disease has well progressed. But despite the failure to properly control blood sugar levels, being treated for the disease would probably delay the onset of more serious problems.

Not ideal, but certainly better than doing nothing at all.

One barrier to more people getting tested is probably the cost. Most people who do not feel sick - and, in the early stages, these chronic conditions have no symptoms - see no reason to pay about $100 every few years to find out whether they have an ailment.

With the Government paying the lion's share of the cost, including consultation with a doctor and testing Pioneer Generation patients for free, this barrier should get knocked down.

Of course, cost is not the only reason people do not go for regular screening. Some just cannot be bothered, some would rather not know that they have a serious ailment and some are not even aware that such screening is good for them.

So, while it is an excellent start, having very cheap health screening alone is not enough.

It must be coupled with greater health education to encourage people to go for the screening every three years, as recommended.

It would be interesting to see what the take-up rate is over the next few years.

Even more significant is whether these screenings result in far fewer complications in the years ahead as people become more health-conscious.

If the take-up rate is high and the programme proves successful in discovering and treating these medical problems early, the next step is to make sure that everyone goes for it.

This is because those who do not and suffer from these diseases would push up healthcare costs for everyone else, since we are now all covered by MediShield Life.

It does not matter whether they take up the Screen for Life offer or do it on their own. The important thing is finding out and treating these problems early.

There are more than 500,000 hospital admissions a year.

Even a drop of a few percentage points would be highly significant, both in terms of cost and in offering a better quality of life to people here.

A version of this article appeared in the print edition of The Straits Times on March 17, 2017, with the headline 'Education needed to get more to take up health screening'. Print Edition | Subscribe