• Vol. 34 No. 3, 238–242
  • 15 April 2005

Acceptance of Prophylactic Surgery and Chemoprevention of Cancer in Singapore – A Survey

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ABSTRACT

Introduction: In addition to surveillance practices, chemoprevention and prophylactic surgery can reduce the risk of cancer in individuals at high risk. Sociocultural factors may have a role to play in such decision making. Little is known regarding the factors that play a role in decision making in Singapore. Materials and Methods: One hundred and two individuals at normal risk completed a questionnaire on the concept of chemoprevention and prophylactic surgery. The results were analysed using the convenience sampling method. Results: Participants were mostly Chinese (94.1%). More than 90% of the respondents answered the section on prophylactic surgery and chemoprevention. Thirty-eight individuals (41.3%) would not consider prophylactic surgery, while 42 (45.7%) would not consider prophylactic surgery now but might consider it in the future. Twenty-five individuals (26.9%) would not consider chemoprevention by taking a medication, 57% would not consider it now but might in the future. Conclusion: A cross-sectional public view suggests that medical prophylaxis is likely to be more acceptable to the general public compared to surgical prophylaxis.


The Singapore healthcare philosophy aims to establish a healthy population through preventive healthcare programmes and public health education. Public education usually emphasises the adverse consequences of harmful habits like smoking, alcohol consumption, poor dietary habits and sedentary lifestyles that may contribute to chronic and fatal diseases such as ischaemic heart disease and cancer. However, cancer remains the number one cause of death in Singapore,1 the 3 most common cancers being lung, breast and colorectal cancer. The majority of cancers are considered sporadic, while only 5% to 10% are considered hereditary.2 In addition to surveillance practices, chemoprevention and prophylactic surgery are potential ways of reducing the risk of cancer in individuals at an elevated risk of cancer.3 Bilateral mastectomy for individuals with BRCA 1 and BRCA 2 mutations, for example, has helped to prevent breast cancer.4 Chemoprevention is an emerging concept, with most evidence of its efficacy found in the case of breast cancer.5,6 The attitudes of Singaporeans towards chemoprevention and prophylactic surgery have not been studied. Sociocultural factors and perceived risks play a role in such decision making.7 We performed a preliminary survey to ascertain the attitudes of individuals towards chemoprevention and prophylactic surgery in a setting of people attending public education talks.

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