Singapore will introduce subsidised genetic testing and expanded insurance coverage for preventive surgeries aimed at reducing the risk of hereditary breast and ovarian cancer (HBOC), Health Minister Ong Ye Kung announced in Parliament during the Committee of Supply debate on March 5.
The new measures are designed to strengthen early detection and prevention efforts for individuals who carry gene mutations linked to HBOC, a condition that significantly increases the likelihood of developing breast and ovarian cancers.
Health authorities estimate that about one in 150 people in Singapore carry a mutation associated with the syndrome. For women with the mutation, the lifetime risk of developing breast or ovarian cancer can be substantially higher than that of the general population. Both cancers remain among the most serious health threats affecting women in the country.
Under the first initiative, the government will introduce subsidised genetic testing in December for individuals considered to be at higher risk. Eligibility will primarily include those with a family history of HBOC or related cancers, such as breast or ovarian cancer.
According to Ong, more than 2,000 people are expected to qualify for the test each year. The government intends to keep the testing “affordable,” with subsidies available and the option for individuals to use their Medisave savings to offset remaining costs.
Those who test positive for the mutation will be offered appropriate preventive care options and medical guidance tailored to their level of risk.
In addition to genetic testing, the government will also extend national health insurance support for certain preventive surgeries. These procedures include preventive mastectomy, the surgical removal of breast tissue to reduce cancer risk, as well as the removal of fallopian tubes and ovaries for individuals at high risk of ovarian cancer.
Preventive mastectomy gained global attention when actress Angelina Jolie revealed in 2013 that she underwent the procedure after testing positive for the BRCA1 gene mutation. Doctors had estimated that the mutation gave her an 87 percent chance of developing breast cancer.
Currently, preventive surgeries for HBOC are not covered under MediShield Life, Singapore’s national health insurance scheme. As a result, patients cannot claim insurance benefits for these procedures.
Ong explained that this policy historically aimed to ensure MediShield Life remained focused on treatment while keeping premiums affordable. However, advances in medical science have increasingly blurred the line between preventive and curative care.
For individuals with a confirmed high-risk mutation, he noted, the inability to undergo preventive surgery could lead to a much higher chance of developing cancer later, potentially requiring extensive treatments such as chemotherapy or curative mastectomy.
Given the strong clinical justification and low risk of misuse, the government determined that extending coverage would be appropriate and sustainable within the insurance framework.
“We will therefore extend MediShield Life and Medisave to cover preventive surgeries for HBOC later this year,” Ong told Parliament.
The announcement was met with applause from members of the chamber, with the health minister noting that the policy change comes just ahead of International Women’s Day on March 8.
Breast reconstruction procedures will continue to be covered under Singapore’s national health insurance schemes.
