Dr Ganesh discusses why Singaporeans should start screening for gastric cancer as early as 40

Stomach cancer, also known as gastric cancer, is typically caused by mutated cells on the upper stomach lining. It is the fifth most common cancer and the third leading cause of cancer deaths worldwide1.

Closer to home, stomach cancer is amongst the top ten cancers diagnosed in Singapore amongst men and women, according to National Cancer Centre Singapore2. It affected 6% of the males (1,605) and 4% of the females (1,160) from 2014 to 2017.

These numbers are certainly no laughing matter and what’s more worrying is the lack of initiative to encourage more Singaporeans to step forward to get tested early. In this article, allow me to share my thoughts on why the current stomach cancer screening measures in Singapore might be too little too late. 

Why should I start screening early for stomach cancer?

High mortality rate in Singapore for stomach cancer patients

While it only affected 6% of men (1,605) and 4% of women (1,160), stomach cancer is the 4th most common cause of cancer death in males, and 5th most common in females, claiming up to 500 lives every year in Singapore.

This is because the cancer is only detected at the later stages, making it difficult to treat. In an article by Channel News Asia, more than two-thirds of the patients are only diagnosed at stage three or four, according to the Singapore Cancer Society2.

When detected early, stomach cancer is very treatable, which I will outline later in this article. We can lower mortality rates by getting screened as early as possible – this includes starting before 50, the recommended screening age in Singapore. 

Note: Screening does not include Gastroclear, which I do NOT recommend at all. 

Stomach cancer symptoms are regularly dismissed

Most patients I’ve seen are diagnosed in the later stages, which corroborates the above trend.

A common reason is that they overlook signs of stomach cancer. It is important to spot these symptoms as they can be easily dismissed as common digestive problems.

I urge everyone to recognise the signs and symptoms of stomach cancer:

No national screening programme for stomach cancer

In neighbouring countries like Japan and Korea, national screening programmes are available for their citizens as their stomach cancer rates are four times higher than in Singapore3.

However, there are no such national screening programmes available in Singapore.

This is why I highly suggest all Singaporeans above 40 to go for scopes regularly on their own, especially if you fall into the high-risk group for stomach cancer. These high-risk individuals include:

  • Males who are more likely to get stomach cancer than females
  • The elderly who are between 60–80 years old
  • Individuals suffering from chronic gastritis or certain infections such as Helicobacter Pylori infection or Epstein Barr Virus infection
  • Those with a family history of stomach cancer, stomach l​ymphoma, and stomach polyps
  • Individuals with poor lifestyle habits such as frequently consuming foods high in salt as well as smoking and drinking regularly

What are the tests for stomach cancer?

Fortunately, stomach cancer is curable if detected and treated early.

It can be detected by an endoscopy procedure. This is the gold standard for diagnosing stomach cancer accurately as it involves a biopsy of the affected tissue.

Gastrectomy Test: A gastrectomy is a specific type of endoscopy whereby the doctor inserts the scope through the mouth to examine your oesophagus, stomach, and duodenum (upper part of the small intestine). 

Colonoscopy Test: Meanwhile, in a colonoscopy, the doctor inserts the endoscope through the rectum to view the inside of the large intestine (colon) and rectum.

For a more detailed analysis on gastrectomy and colonoscopy, I’ve previously written an article on the difference between an endoscopy, colonoscopy, and gastroscopy

What are the treatment options for stomach cancer?

Radiotherapy, chemotherapy, gastrectomy surgery, and specific medication are treatment options to consider, depending on the individual and the stage of cancer.

Similar treatments can yield different outcomes in patients. This is why I consider every case to be unique.

For more detailed treatment options for stomach cancer, feel free to leave me a note and I’ll try my best to get back to you. 


  1. Rawla, P., & Barsouk, A. (2019). Epidemiology of gastric cancer: global trends, risk factors and prevention. Przeglad gastroenterologiczny, 14(1), 26–38. https://doi.org/10.5114/pg.2018.80001
  2. National Cancer Centre Singapore . (2021). Retrieved from Cancer Statistics: https://www.nccs.com.sg/patient-care/cancer-types/cancer-statistics
  3. World Cancer Research Fund. (2021). Retrieved from Stomach cancer statistics: https://www.wcrf.org/dietandcancer/stomach-cancer-statistics/

This article was written and medically reviewed by Dr. Ganesh Ramalingam, M.D.