Subsidised genetic testing for hereditary breast, ovarian cancer starts Dec 1

From December 1, 2026, individuals who are at risk of hereditary breast and ovarian cancer (HBOC) will be able to undergo genetic testing at three public healthcare clusters.

This was announced by the Ministry of Health (MOH) in a news release on Thursday (Oct 5), following up on the ministry's Committee of Supply debate earlier in March.

"(Subsidised genetic testing for HBOC) is part of the Ministry of Health (MOH)’s broader strategy to enhance preventive care in Singapore," the ministry said.

During the debate, Minister for Health Ong Ye Kung said that an estimated one in 150 people in Singapore carry a gene mutation associated with HBOC, which may increase a woman's risk of developing the cancers.

He added that about 2,000 people are expected to be eligible for the subsidised HBOC genetic testing.

Up to 70 per cent of the costs will be subsidised through a means-testing process, and the remaining can also be offset using MediSave.

For patients who wish to undergo surgical preventive interventions such as mastectomy or removal of their fallopian tubes and ovaries, part of the costs can be covered by MediShield Life and MediSave from the second half of 2026.

How the enhanced financing support works

For now, subsidised HBOC genetic testing will be available at cancer specialist outpatient clinics at the National Cancer Centre Singapore, the National University Cancer Institute Singapore, and Tan Tock Seng Hospital.

It is recommended for individuals with breast and/or ovarian cancer with risk factors for HBOC, first-degree relatives of an individual who carries a HBOC-associated gene variant, and those with a strong familial history suggestive of HBOC but do not have cancer-affected first-degree relatives available for testing.

Eligible Singaporeans and permanent residents can enjoy means-tested subsidies of up to 70 per cent on the genetic test, while seniors from the Pioneer Generation and Merdeka Generation are eligible for additional subsidies.

The Medisave chronic and preventive care scheme limits, which will be raised from January next year, can be used to further offset the cost of the genetic test after subsidies.

In the interim period before the enhanced scheme takes effect, the existing Medisave limits will be extended to cover the HBOC genetic test, MOH said.

Seniors aged 60 and above may use Flexi-Medisave to defray any additional out-of-pocket costs.

Doctors will recommend the first-degree relatives of those who test positive to undergo genetic testing, according to the release. This form of cascade testing will be similarly supported with subsidies and Medisave usage.

"After subsidies and Medisave, individuals with sufficient Medisave balances may expect $0 in out-of-pocket payment for HBOC genetic testing," the ministry said.

It added that subsidies for HBOC genetic testing apply to all eligible individuals, regardless of gender.

This, MOH explained, is important because mutation carriers, including males, can pass the mutation to their children.

"If an individual is unsure whether they or their family members should be tested, they are encouraged to speak to their doctor, who can assess their risk and refer them accordingly."

Downstream interventions

But understanding an individual’s genetic predisposition is only the first step, with the real benefit coming from acting on that result through downstream interventions such as intensified surveillance, risk-reducing surgeries, and chemoprevention.

This includes risk-reducing mastectomy (RRM), which removes breasts, reduces breast cancer risk by at 90 per cent or more in individuals with HBOC-associated gene variants; and, risk-reducing bilateral salpingo-oophorectomy (RRBSO), which removes both the fallopian tubes and ovaries, thereby reducing ovarian cancer risk by 80 per cent or more.

Following its earlier announcement that MediShield Life coverage will be extended to cover cover preventive surgeries in selected instances, the ministry said Medisave use will also be extended to RRM and RRBSO.

Meanwhile, MediShield Life and Medisave coverage for RRM have already been extended since September 2026.

Similar MediShield Life and Medisave coverage for RRBSO will be extended by the end of the year.

Continued affordability in subsequent intensified surveillance such as yearly magnetic resonance imaging and/or mammograms and drug therapy are also in place.

"By making genetic testing and the full range of downstream interventions accessible and affordable, MOH aims to reduce the burden of hereditary cancers on individuals, families, and the broader healthcare system," the ministry said.

It added that the suite of measures available to Singaporeans will continue to be reviewed and strengthened so that more people can benefit from early detection and timely intervention in the years ahead.

从 2026 年 12 月 1 日起，有遗传性乳腺癌和卵巢癌 (HBOC) 风险的人士将能够在三个公共医疗保健集群接受基因检测。

卫生部 (MOH) 于周四（10 月 5 日）发布新闻稿宣布了这一消息，此前该部在 3 月份举行的财政预算委员会辩论中做出了回应。

“（针对遗传性乳腺癌/卵巢癌综合征的基因检测补贴）是新加坡卫生部加强预防保健的更广泛战略的一部分，”卫生部表示。

在辩论中，卫生部长王乙康表示，据估计，新加坡每 150 人中就有 1 人携带与遗传性乳腺癌/卵巢癌综合征 (HBOC) 相关的基因突变，这可能会增加女性患这种癌症的风险。

他还补充说，预计约有 2000 人将有资格获得 HBOC 基因检测补贴。

高达 70% 的费用将通过经济状况调查程序获得补贴，剩余部分也可以使用保健储蓄 (MediSave) 来抵消。

对于希望接受乳房切除术或输卵管和卵巢切除术等外科预防性干预的患者，从 2026 年下半年起，MediShield Life 和 MediSave 可以报销部分费用。

加强融资支持如何运作

目前，新加坡国家癌症中心、新加坡国立大学癌症中心和陈笃生医院的癌症专科门诊将提供有补贴的 HBOC 基因检测。

建议对患有乳腺癌和/或卵巢癌且有 HBOC 风险因素的个体、携带 HBOC 相关基因变异个体的直系亲属以及有强烈的 HBOC 家族史但无患癌直系亲属可供检测的个体进行检测。

符合资格的新加坡公民和永久居民可享受高达 70% 的基因检测费用补贴，而建国一代和独立一代的老年人则有资格获得额外补贴。

从明年一月起，保健储蓄慢性病和预防保健计划的限额将有所提高，补贴后可用于进一步抵消基因检测的费用。

卫生部表示，在加强版方案生效前的过渡期内，现有的保健储蓄限额将扩大到涵盖HBOC基因检测。

60岁及以上的长者可以使用灵活保健储蓄账户来支付任何额外的自付费用。

根据新闻稿，医生将建议检测结果呈阳性者的直系亲属接受基因检测。这种级联式检测也将获得补贴和保健储蓄账户（Medisave）的使用支持。

“在获得补贴和保健储蓄后，保健储蓄余额充足的个人进行HBOC基因检测可能无需自付任何费用，”卫生部表示。

声明还补充说，HBOC基因检测补贴适用于所有符合条件的个人，无论性别。

卫生部解释说，这一点很重要，因为突变携带者（包括男性）可以将突变遗传给他们的孩子。

“如果个人不确定自己或家人是否应该接受检测，建议咨询医生，医生可以评估风险并做出相应的转诊决定。”

下游干预措施

但了解个人的遗传倾向只是第一步，真正的益处在于通过后续干预措施（如加强监测、降低风险的手术和化学预防）来应对这一结果。

这包括风险降低性乳房切除术（RRM），切除乳房，可使携带 HBOC 相关基因变异的个体患乳腺癌的风险降低 90% 或更多；以及风险降低性双侧输卵管卵巢切除术（RRBSO），切除输卵管和卵巢，从而使卵巢癌的风险降低 80% 或更多。

继此前宣布终身健保计划的承保范围将扩大到特定情况下的预防性手术后，卫生部表示保健储蓄的使用范围也将扩大到农村救治和农村外科手术。

与此同时，自 2026 年 9 月起，终身健保计划和保健储蓄计划对 RRM 的保障范围已经延长。

类似的终身健保计划和保健储蓄计划对RRBSO的保障将在年底前延长。

后续强化监测（如每年进行磁共振成像和/或乳房X光检查以及药物治疗）的费用也将继续保持在可承受的范围内。

卫生部表示：“通过使基因检测和所有后续干预措施变得可及且负担得起，卫生部旨在减轻遗传性癌症对个人、家庭和更广泛的医疗保健系统的负担。”

声明还补充说，新加坡人可获得的各项措施将继续进行审查和加强，以便在未来几年里，更多的人能够从早期发现和及时干预中受益。