NCCS and NTU Singapore-led Cancer Prevention Research Institute Launches Studies to Evaluate Multi-Cancer Early Detection Tests and Tackle Metabolic Dysfunction-Linked Cancers in Singapore

• A clinical trial led by NCCS will evaluate the use of multi-cancer early detection tests to identify early-stage cancers in individuals with high risk due to pre-malignant conditions or hereditary cancer syndromes 
• A study led by NTU’s LKCMedicine will develop targeted cancer screening and prevention strategies for individuals with metabolic dysfunction

Singapore, 13 May 2026 – The Research Institute for Cancer Prevention, Screening and Early Detection (RISE), jointly led by the National Cancer Centre Singapore (NCCS) and Nanyang Technological University, Singapore (NTU Singapore), has announced the launch of two studies; one led by NCCS to evaluate multi-cancer early detection (MCED) tests and another led by the Lee Kong Chian School of Medicine (LKCMedicine) at NTU Singapore to develop targeted screening and prevention for metabolic dysfunction-linked cancers in Singapore.

MCED tests are an emerging cancer screening technology worldwide but there is limited evidence currently to show that they improve population health outcomes. The NCCS team will conduct a clinical trial to comprehensively evaluate the use of MCED tests to identify early-stage cancers in individuals with elevated risk due to pre-malignant conditions or hereditary cancer syndromes, and use the evidence-based insights to assess the feasibility for integration into cancer screening for at risk populations.

The LKCMedicine study focuses on individuals with metabolic risk factors, such as diabetes, excess body fat, high cholesterol or high blood pressure. These conditions increase the risk of developing several cancers, including colorectal, lung and breast cancer. Known as the Cancer Risk Assessments and Early detection (CRAnE) study, it aims to test multi-cancer risk assessment methods in primary care to tailor screening and prevention advice, so that individuals complete the screening tests most relevant to their risks.

Why Cancer Prevention and Early Detection Matter More Than Ever

Global analysis by the World Health Organisation and its International Agency for Research on Cancer found that up to 4 in 10 of all new cancer cases in 2022 were linked to preventable causes such as tobacco use, alcohol consumption, high body mass index, physical inactivity and cancer-causing infections¹.

Locally, the latest statistics from the Singapore Cancer Registry show that cancer incidence rates are steadily rising², yet local cancer screening participation rates remain significantly behind global counterparts and international benchmarks. The 2024 National Population Health Survey revealed low cancer screening participation rates among the eligible population here, with breast cancer screening participation at just 35.2%, while cervical and colorectal cancer screening rates are at 44.9% each³. International benchmarks for cancer screening participation aim for 70% or higher, to ensure population-level reduction in mortality and incidence.

This data, coupled with the established fact that early cancer detection enables timely treatment that is more effective, less complex and less costly, underscores the urgent need to explore more innovative screening approaches to detect and prevent more cancer types early.

“The next major leap in cancer control will not only come from better, more innovative treatments, but also from improving the ability to prevent and detect cancers earlier when the chances of cure are highest. RISE was established to generate robust evidence that Singapore can use to shape and design screening and prevention strategies that are effective, accessible and tailored to the needs of our Asian population,” said Professor Ravindran Kanesvaran, Co-Director of RISE; Chairman & Senior Consultant, Division of Medical Oncology, NCCS.

“There are currently no centres in Asia that conduct clinical translational research, shape policy and deliver education focused on cancer prevention and early detection. RISE fills this critical gap in the region. It also recognises the important role of primary care across the cancer continuum, spanning prevention, screening, early diagnosis, survivorship and health service integration. Through RISE, LKCMedicine and NCCS have an opportunity to build on Singapore’s healthcare policies and improve the delivery of cancer screening services in primary care and hospitals,” said Professor Jon Emery, Co-Director of RISE; Professor of Family Medicine, LKCMedicine, NTU.

Evaluating the Potential of Multi-Cancer Early Detection (MCED) Tests

MCED tests, which are minimally invasive and require only a blood draw, are gaining interest as an approach to address screening challenges such as psychological and cultural barriers.

MCED tests are currently not part of Singapore’s national cancer screening programme due to limited evidence demonstrating their cost effectiveness and benefit at a population level. While they hold potential, MCED tests are not a replacement for recommended cancer screening tests, including screening at population level using mammogram (for breast cancer), Pap smear and Human Papillomavirus Test (for cervical cancer), and Fecal Immunochemical Test and colonoscopy (for colorectal cancer).

Global research on MCED technology is limited in scope, lacking long-term studies and focusing heavily on Western populations in the US and UK. This highlights the need to conduct research in Singapore to better understand the utility and relevance of MCED testing for our local population.

To address this, NCCS will conduct a clinical trial to assess the ability of MCED tests to detect early-stage cancers in individuals with elevated risk, and generate real-world evidence on whether the tests improve cancer diagnosis, staging, and survival. The clinical trial, which will start in the second half of 2026, aims to recruit 1,000 individuals in Singapore who have higher cancer risk due to pre-malignant conditions and/or hereditary cancer syndromes. Based on their MCED test results, participants will receive follow-up care and be monitored at NCCS for up to 5 years (See Annex A for more info):

“MCED tests hold promise in the fight against cancer, but promise alone is not enough to justify population-wide screening. We need rigorous evidence to understand how these tests perform in our population, what diagnostic follow-up and care is needed after a positive test result, and how individuals experience the screening and care pathway. With this NCCS-led clinical trial, we aim to assess the ability of MCED testing to help detect cancers earlier, reduce the burden of advanced disease and improve patient outcomes at a population level,” said Professor Ravindran Kanesvaran.

Addressing Metabolic Dysfunction-linked Cancers, a Growing Concern

Globally, advances in cardiovascular management have helped reduce the overall disease burden attributable to metabolic risk factors. However, the burden from metabolic dysfunction linked cancers is on the rise. Metabolic dysfunction is associated with increased risk of several cancers, including liver, colorectal, pancreatic, endometrial, breast, oesophageal and lung cancer.

Often diagnosed at a late stage, these cancers account for a significant share of cancer deaths in Singapore. It is therefore crucial to increase screening participation among individuals with metabolic dysfunction and develop targeted approaches to multi-cancer screening and prevention.

Through the CRAnE study, LKCMedicine aims to improve early detection and intervention for metabolic dysfunction-linked cancers. Researchers from LKCMedicine will partner with NHG Polyclinics and private general practitioners to identify patients with metabolic dysfunction in primary care settings, and to test advanced multi-cancer risk prediction assessment models that will generate tailored reports outlining patients’ cancer risks and the screening tests they should complete. Cancer risk assessment will include polygenic risk scores which estimate how multiple variations in DNA may increase or decrease a person’s risk for specific diseases.

The initial study, involving 200 people with metabolic risk factors, will begin in the second half of 2026. Its results will be used to design a larger randomised controlled trial to evaluate the cost-effectiveness of multi-cancer screening and prevention for patients with metabolic dysfunction. (See Annex B for more info)

“By combining advances in cancer risk prediction with primary care-based prevention and early detection efforts, the study seeks to encourage doctors and patients to act fast, improve early diagnosis and reduce the burden of cancer. We hope to improve long-term health outcomes for Singaporeans at risk of multiple cancers,” said Professor Jon Emery.

The Role of RISE to Boost Preventive Health Efforts

RISE was established in 2025 with the support of a generous gift of $2.5 million in memory of Mr Murdaya Widyawimarta Po to the NCCS Cancer Fund and $1 million in seed funding from LKCMedicine. The two new studies also benefit from these funding.

In line with the national Healthier SG initiative to boost preventive health, RISE works with all three public healthcare clusters in Singapore and other partners, to drive evidence-based policy recommendations and implementation strategies in primary care that improve cancer screening and early detection. The research institute combines NCCS' clinical care expertise and research capabilities with LKCMedicine's multidisciplinary primary care research and academic strengths, creating a platform to address critical challenges in cancer prevention and early detection in Asia. (See Annex C for more info on RISE)

-END-

¹https://www.who.int/news/item/03-02-2026-four-in-ten-cancer-cases-could-be-prevented-globally 

²https://www.nrdo.gov.sg/docs/librariesprovider3/default-document-library/singapore-cancer-registry-infographic-2023.pdf?sfvrsn=3e72976a_1

³https://www.hpb.gov.sg/community/national-population-health-survey/survey-findings

For media enquiries, please contact:

Lo Sok Wan
National Cancer Centre Singapore
Corporate Communications
Email : lo.sok.wan@nccs.com.sg 

Foo Jie Ying
Nanyang Technological University, Singapore
Corporate Communications Office
Email : jieying@ntu.edu.sg 

About the National Cancer Centre Singapore

The National Cancer Centre Singapore (NCCS) is a leading national and regional tertiary cancer centre dedicated to advancing cancer care, research and education. With a comprehensive suite of specialties and services, NCCS treats all cancers and offers personalised and multidisciplinary care to ensure that patients receive holistic, compassionate care and support. Advanced and innovative treatments such as proton therapy at the Goh Cheng Liang Proton Therapy Centre, immunotherapy, and cell therapy are available at NCCS to give patients the best treatment outcomes.

Ranked among the top cancer centres in Asia, NCCS is globally recognised for its research expertise, with clinicians and scientists collaborating with local and international partners to conduct cutting-edge clinical and translational research that makes a real impact and offers hope of a cancer-free tomorrow. As an academic healthcare institution, NCCS is committed to nurturing future generations by delivering specialised training to local and overseas oncology healthcare professionals. For more information, please visit www.nccs.com.sg.

About Nanyang Technological University, Singapore

A research-intensive public university, Nanyang Technological University, Singapore (NTU Singapore) has 40,000 undergraduate and postgraduate students in the Business, Computing & Data Science, Engineering, Humanities, Arts, & Social Sciences, Medicine, Science, and Graduate colleges.

NTU is also home to world-renowned autonomous institutes – the National Institute of Education and S Rajaratnam School of International Studies – and various leading research centres such as the Earth Observatory of Singapore, Nanyang Environment & Water Research Institute, Energy Research Institute @ NTU (ERI@N), and Singapore Centre for Environmental Life Sciences Engineering.

Under the NTU Smart Campus vision, the University harnesses the power of digital technology and tech-enabled solutions to support better learning and living experiences, the discovery of new knowledge, and the sustainability of resources.

Ranked amongst the world’s top universities, the University’s main campus is also frequently listed among the world’s most beautiful. Known for its sustainability, NTU has achieved 100% Green Mark Platinum certification for all its eligible building projects. Apart from its main campus, NTU also has a medical campus in Novena, Singapore’s healthcare district. For more information, visit www.ntu.edu.sg

ANNEX A

Multi-Cancer Early Detection (MCED) Clinical Trial

Led by NCCS, the MCED clinical trial will be rolled out in the second half of 2026 to assess how well current MCED tests detect early-stage cancers in individuals with elevated risk. The study will generate real-world evidence to determine if the tests improve clinical outcomes in terms of cancer diagnosis, staging, and survival. The data gathered will be linked with TRUST (Trusted Research and Real-world-data Utilisation and Sharing Tech), Singapore’s national, secure data platform designed to bring together anonymised health data to accelerate research, public health policy planning and clinical innovations.

The study aims to recruit 1,000 individuals with higher cancer risk due to:

• Pre-malignant conditions (e.g. liver cirrhosis, chronic pancreatitis) 
• Hereditary cancer syndromes (e.g. Lynch Syndrome, Familial Adenomatous polyposis, Li-fraumeni Syndrome) 

All participants will undergo a blood draw for MCED testing, take a questionnaire on their personal and family health history and receive care protocols based on their MCED test results. Participants will be followed up at NCCS for up to 5 years.

• Positive MCED test results 
  • Those with a positive result will receive further diagnostic tests such as CT/MRI scans and/or biopsies to confirm if cancer is present. 
  • If a definitive cancer diagnosis is made, the participant will be referred to a multidisciplinary team of specialists at NCCS for further review and treatment planning. 
  • If there is no definitive diagnosis of cancer, the participant will undergo a repeat MCED test after 6 months and continue to be monitored for up to 5 years. 
• Negative MCED test results 
  • Those with a negative result will undergo repeat MCED testing yearly and be monitored for up to 5 years. The participant will also undergo screening for breast, cervical and colorectal cancers as appropriate, as per national screening guidelines. 

Participants on the trial will not need to pay for the MCED tests. Those with a positive MCED result will receive diagnostic tests as per routine clinical care and will be charged accordingly based on prevailing fees and their subsidy eligibility.

NCCS will work with the SingHealth Primary Care Network to recruit participants for the clinical trial. More details on the clinical trial recruitment will be announced when the trial is rolled out in the second half of 2026.

ANNEX B

The Cancer Risk Assessments and Early detection (CRAnE) Study

Led by LKCMedicine at NTU, the CRAnE study begins in the second half of 2026 with an initial feasibility and acceptability study that leverages data from NHG Health polyclinics and private general practices to identify 200 patients with metabolic risk factors for cancer. People with metabolic dysfunction are at increased risk of multiple cancers, including breast, colorectal, pancreatic, liver and lung cancers.

The team will conduct the study by offering a multi-cancer risk assessment to patients with metabolic risk factors and providing tailored recommendations about the right cancer screening tests for them.

Multi-cancer risk assessment

Existing polygenic risk scores for breast, colorectal and prostate cancers, along with additional risk assessment models – such as those for liver, pancreatic and lung cancers – will be used to assess a person’s five-year and lifetime risks of these cancers. Patients in the study will receive a personal risk report that provides specific recommendations on the types of cancer screening they need based on their cancer risks.

CRAnE will evaluate the feasibility and acceptability from patient and health service perspectives. The team will collect preliminary data on behavioural and clinical outcomes (e.g. screening participation, lifestyle changes), using patient-reported outcome measures and qualitative interviews.

The results of the study will be used to design a larger, randomised controlled trial to provide evidence on the cost-effectiveness of this multi-cancer risk assessment approach.

ANNEX C

Research Institute for Cancer Prevention, Screening and Early Detection (RISE)

Co-led by NCCS and LKCMedicine, RISE was established in September 2025 to address critical challenges in cancer prevention and early detection. RISE works with all three public healthcare clusters in Singapore and other partners to drive evidence-based policy recommendations and implementation strategies to boost cancer screening and early detection initiatives in Singapore.

Key partners:

• SingHealth (e.g. hospitals, national specialty centres) 
• NHG Health 
• National University Cancer Institute Singapore 
• Saw Swee Hock School of Public Health 
• Singapore Translational Cancer Consortium 
• Primary Care partners (e.g. Polyclinics and GP clinics)

RISE aims to be a leading Asian centre for clinical translational research, policy and education focused on cancer prevention and early detection. It is strategically positioned to address this critical challenge by leveraging innovative research, education, and strategic partnerships with local and regional collaborators.

RISE’s key research priorities: 

1. Precision Health: To develop advanced risk prediction models and innovative screening methods. 
2. Primary Care: To test evaluation and implementation strategies, cancer risk communication and health services research. 
3. Education: To develop postgraduate courses, workshops, conferences, policy/practice initiatives to train the next generation of cancer preventive health experts.

Through these interconnected strategic areas, RISE aims to create a comprehensive approach to cancer prevention that spans laboratory discovery to population-level implementation, ensuring that scientific advances translate into meaningful improvements in public health outcomes. The national HealthierSG initiative offers an unparalleled opportunity to improve the delivery of cancer screening services in primary care, and RISE aims to support this effort by informing future models of multi-cancer screening that could be applicable to the HealthierSG framework.

RISE also actively involves patients, caregivers, and communities when designing and conducting research studies, by embedding Patient and Public Involvement and Engagement (PPIE) in all its projects and working closely with initiatives such as the Asian Centre for Health Behavioural Insights and Interventions (HABITS).