BreastScreen Singapore: Lessons Learnt
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1 BreastScreen Singapore: Lessons Learnt Anushka Mangharam Manager, Screening Policy & Planning Department Regional Health & Community Outreach Division Health Promotion Board, Singapore
2 Outline Singapore: An Introduction Singapore s Healthcare System Burden of Disease Screen for Life: BreastScreen Singapore Background Publicity & Awareness Quality Assurance (QA) Performance
3 SINGAPORE: AN INTRODUCTION Image source:
4 Image source: Image source: Image source:
5 Image source: INGAPORE S HEALTHCARE SYSTEM
6 Singapore s Healthcare System Funding Source: Ministry of Health Health Promotion Board Regulation Services & facilities 6 Regional Health Systems Primary healthcare facilities - Private GP clinics - Government polyclinics Hospitals - Public hospitals (6 + 2) - Private hospitals Dental Services Intermediate & Longterm Care Services (Residential, Community) Traditional Chinese Medicine practices
7 Image source: URDEN OF DISEASE
8 Singapore s Burden of Disease Distribution of Disability-Adjusted Life Years (DALYs) by Broad Cause Group 25% 20% 20% 19% 15% 14% 15% 10% 10% 5% 7% 6% 5% 4% 0% Data Source: Singapore Burden of Disease Study, 2010, Ministry of Health
9 Singapore s Burden of Disease: Cancers Ten Most Frequent Cancers (%) in Females, Data Source: Singapore Cancer Registry Interim Annual Report Trends in Cancer Incidence in Singapore ( )
10 HEALTH PROMOTION BOARD S SCREEN FOR LIFE
11 National Screening Programmes Guided by the recommendations of the Screening Test Review Committee (STRC) PROGRAMMES WHAT & WHO WHERE BreastScreen Singapore (BSS) CervicalScreen Singapore (CSS) A national programme which provides subsidised mammogram services to women 40 & above A national programme which provides subsidised Pap smear services to women 25 & above 15 Polyclinics + 1 Pvt. HPB + 1 VWO + 1 Mammobus 18 Polyclinics National Colorectal Cancer Screening Programme (NCRCP) A national programme which provides subsidised FIT testing services to adults 50 & above GP clinics (~350) Screen for GP Clinics (SFL) Community Functional Screening Programme (CFSP) A national programme which provides subsidised chronic disease & cancer* screening services to adults 40 & above A pilot programme which provides subsidised functional screening services to older adults 60 & above GP clinics (~350) Community (CCs, RCs, VWOs)
12 BreastScreen Singapore (BSS): Background Accessibility of Screening Services Woodlands Yishun Choa Chu Kang Jurong Bukit Batok Sengkang Ang Mo Kio Hougang SCS TTSH Toa Payoh Tampines Pasir Ris CGH Clementi NUH Queenstown NCC Bukit Merah Radiologic Clinic MediRad Geylang Legend 17 Screening Centres at Polyclinics, HPB and 1 VWO 1 Reading Centre 4 Reading & Assessment Centres NHGD s Mammobus
13 Publicity & Awareness
14 BSS Quality Assurance Established a QA Framework with guidelines and standards for BSS and Medisave-approved centres Introduced double reads of mammograms; (+ 3 rd reader for discordant cases) Adopted a multi-disciplinary approach towards breast cancer management with a pool of dedicated clinicians ensuring continuum of care for patients Biennial on-site audits carried out to screening, reading and assessment centres to monitor centre performance on clinical indicators: Cancer detection rate (invasive cancers) In-situ cancer detection rate Benign operative biopsy rate in assessed women Recall rate Quality improvement measures (e.g. internal QC checks, regular clinical reviews) in place for centres with deficiencies On going capacity building for medical and allied healthcare professionals (eg. BreastScreen Singapore biennial seminar)
15 QA documents for BSS Screening, Reading & Assessment Centres Certificates awarded to BSS centres who meet the standards
16 Comparison with Other Countries Source: National Breast Cancer Screening Programme, Singapore: Evaluation of participation and performance indicators (2015)
17 Thank You
18 For More Information..
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