Screening Before Symptoms: A Singapore Preventive Health Guide

What screening can do, what it cannot do, and why feeling well is not the same as being risk-free

This book provides general health education and does not replace individual diagnosis or emergency medical care.

CHAPTER 1

Health Screening When You Feel Well: A Singapore Guide

Screening is designed to detect certain conditions before symptoms appear. Learn how Healthier SG Screening and personalised primary-care advice fit together.

Key points

Screening recommendations depend on age, sex, risk factors and previous results.

More tests are not automatically better; unnecessary tests can create false alarms and follow-up procedures.

A primary-care doctor can help choose appropriate screening and follow up abnormal results.

Why this deserves attention

A common reason for avoiding screening is “I feel fine”. But screening is specifically meant for people who may have no symptoms. High blood pressure, high cholesterol, diabetes and several cancers can be present before a person feels ill. The goal is not to search for every possible disease; it is to use evidence-based tests that have more benefit than harm for the right people.

What makes it more important

Singapore’s 2026 Screening Test Review Committee updated recommendations for several cancers and chronic diseases. MOH emphasises screening in primary care where results can be interpreted and followed up properly. Healthier SG Screening provides subsidised nationally recommended screening for eligible Singaporeans.

What to do next

Ask your enrolled Healthier SG clinic or usual GP what is due rather than relying on a checklist saved years ago. Screening schedules can change and higher-risk people may need a different plan. Keep a simple record of when each test was done and what follow-up was recommended.

Where TCM may fit

TCM health maintenance should not replace evidence-based screening. Feeling more energetic after lifestyle or TCM care also does not confirm that blood pressure, cholesterol, glucose or cancer screening is normal.

When not to wait

Screening is for people without concerning symptoms. If you have unexplained bleeding, a new lump, major weight loss, persistent chest/breathing symptoms or other red flags, seek medical assessment rather than waiting for a routine screening appointment.

CHAPTER 2

Home Blood Pressure: How to Get a Reading That Is Actually Useful

Home blood pressure can be useful when technique is consistent. Learn about rest, cuff position, repeated readings and what not to do with one isolated number.

Key points

Sit quietly before measuring and support the arm.

Use the same general time and method when tracking trends.

Repeated very high or very low readings deserve medical advice; do not self-adjust medicines from one reading.

Why this deserves attention

Home blood-pressure monitoring can reveal patterns that a single clinic reading may miss, but poor technique can create confusing numbers. Recent exercise, caffeine, smoking, talking, a full bladder, an unsupported arm or the wrong cuff size can all affect the result. The aim is not to chase the lowest possible number; it is to create readings that are comparable over time.

What makes it more important

The meaning of a reading depends on context. Pain, fever, anxiety and poor sleep can temporarily raise blood pressure. Some medicines can lower it or make standing dizziness worse. A person already diagnosed with hypertension should follow the monitoring plan and target discussed with the treating doctor rather than adopting a generic internet target.

What to do next

Write down the date, time, readings, pulse and anything unusual such as headache, dizziness, missed medication or illness. Bring the log and your monitor to a medical appointment if readings seem inconsistent. Regular screening remains important for people who have never been diagnosed because hypertension often causes no symptoms.

Where TCM may fit

TCM treatment should not be used to “correct” a single home reading. If you receive acupuncture, Tuina or herbs while taking blood-pressure medicines, tell the practitioner about your diagnosis, current medicines and whether you have dizziness or fainting.

When not to wait

If very high blood pressure is accompanied by chest pain, severe breathlessness, new neurological symptoms, confusion or collapse, seek emergency care rather than repeating the measurement again and again at home.

CHAPTER 3

High Cholesterol: A Silent Risk You Cannot Feel

High cholesterol often causes no symptoms. Learn why blood tests, overall cardiovascular risk and follow-up matter even when you feel well.

Key points

A normal-looking body does not guarantee normal cholesterol.

A single number should be interpreted together with your overall cardiovascular risk.

If treatment is prescribed, do not stop it because you “feel fine”.

Why this deserves attention

Cholesterol is carried in the blood and is essential for normal body function, but an unhealthy lipid pattern can contribute to plaque formation in arteries over time. The difficult part is that high cholesterol generally does not make a person feel unwell. Energy level, body size and fitness are poor substitutes for a blood test. A person can exercise regularly and still have a lipid problem because age, genetics, diabetes, smoking, blood pressure and other factors all influence cardiovascular risk.

What makes it more important

Family history of early heart disease, smoking, diabetes, high blood pressure, kidney disease and increasing age can make an abnormal lipid result more important. Extremely high LDL can also suggest inherited cholesterol disorders. The practical question is therefore not simply “Is my cholesterol high?” but “What does this result mean for my personal risk, and what target is appropriate for me?”

What to do next

Use routine screening rather than symptoms to find out. Keep copies of results so you can see trends. Discuss diet, activity, weight, smoking and medicines with a primary-care doctor rather than relying on supplements marketed as “cholesterol cleansers”. If you are eligible for Healthier SG Screening, cardiovascular risk screening can help identify high blood cholesterol together with other silent risk factors.

Where TCM may fit

TCM can be discussed for other concerns such as sleep, stress or musculoskeletal discomfort, but a traditional pattern diagnosis cannot tell you whether LDL or total cardiovascular risk is controlled. Herbal products should also be disclosed because some may interact with prescribed medicines or affect the liver.

When not to wait

Chest pressure, severe breathlessness, collapse, new weakness on one side or other possible heart-attack/stroke symptoms are emergencies and should not be treated as a cholesterol problem to “manage later”.

CHAPTER 4

Prediabetes: Why “I Feel Fine” Is Not Reassuring

Prediabetes often has no obvious symptoms. Learn why screening, weight, activity, sleep and follow-up matter before complications appear.

Key points

Prediabetes is usually found by testing, not symptoms.

Weight, waist size, family history, previous gestational diabetes and activity level affect risk.

Improvement is possible, but follow-up matters even after lifestyle changes.

Why this deserves attention

Prediabetes means blood glucose is higher than normal but not yet in the diabetes range. Most people do not feel different. Waiting for thirst, frequent urination or weight loss is therefore a poor strategy; those symptoms can appear later or may have other causes. Screening identifies risk while there is still time to make meaningful changes.

What makes it more important

Sleep deprivation, highly sedentary routines and weight gain around the abdomen can add to metabolic risk. In Singapore, irregular meals, sweet drinks, long work hours and limited activity can make change feel difficult; small repeatable changes are more useful than a short extreme diet.

What to do next

Use screening and your doctor’s follow-up plan to understand fasting glucose/HbA1c and other cardiovascular risk factors. If eligible, Healthier SG Screening can help identify diabetes risk together with blood pressure, cholesterol and obesity measures.

Where TCM may fit

TCM food advice may be used as a way to think about regular meals and overall dietary habits, but it should not replace glucose testing. Be cautious with herbal products claiming to “lower sugar” because they may interact with medicines or affect liver/kidney function.

When not to wait

Severe dehydration, persistent vomiting, confusion, collapse or breathing difficulty in a person with very high or very low glucose requires urgent medical care.

CHAPTER 5

Bowel Cancer: Screening Before Symptoms and Warning Changes Not to Ignore

Colorectal cancer can be silent early. Learn the role of FIT screening in Singapore and when blood or bowel changes need medical review instead.

Key points

Screening is for people without symptoms; symptoms need medical assessment.

Blood in stool, persistent bowel-habit change or unexplained anaemia should not be dismissed as “heatiness” or piles without review.

Family history and previous polyps can change the recommended screening plan.

Why this deserves attention

Colorectal cancer can develop slowly from polyps and may cause no symptoms in its early stages. That is why screening matters. The Faecal Immunochemical Test (FIT) looks for small amounts of blood in stool that may not be visible. A positive FIT does not mean someone definitely has cancer, but it requires proper follow-up.

What makes it more important

Other warning changes include persistent abdominal discomfort, unexplained weight loss and feeling that the bowel does not empty normally. These symptoms are common and often have non-cancer causes, but persistence is the reason to investigate rather than guess.

What to do next

Eligible people in Singapore can access colorectal cancer screening through Healthier SG Screening. If you already have symptoms such as visible blood in stool, do not use a normal previous FIT result as reassurance — see a doctor.

Where TCM may fit

TCM may help some people discuss bowel habits, diet or comfort, but it cannot determine whether bleeding comes from cancer, polyps, inflammatory bowel disease or haemorrhoids. Medical evaluation should come first when red flags are present.

When not to wait

Seek prompt care for significant ongoing rectal bleeding, black tarry stools, fainting, severe abdominal pain, persistent vomiting or marked weakness.

CHAPTER 6

Breast Changes: Lumps, Skin or Nipple Changes and Mammogram Awareness

Most breast changes are not cancer, but new persistent changes deserve assessment. Learn why screening mammograms matter even without a lump.

Key points

Notice a new lump, persistent thickening, skin dimpling, nipple inversion or unusual discharge.

Changes that persist after a menstrual cycle deserve review.

A normal mammogram does not mean future new symptoms should be ignored.

Why this deserves attention

Breast cancer can be found before symptoms appear, which is why mammogram screening is used for appropriate age groups. At the same time, a new lump or visible breast change is not “screening” — it is a symptom that should be assessed. Pain alone does not reliably distinguish benign from serious causes.

What makes it more important

Family history, previous breast disease and certain reproductive/hormonal factors may change personal risk. Your doctor can advise whether standard population screening is appropriate or whether a different plan is needed.

What to do next

Healthier SG Screening includes subsidised breast cancer screening for eligible women through selected services. Screening recommendations can change, so check current eligibility and interval with your usual doctor or Healthier SG clinic.

Where TCM may fit

TCM cannot determine whether a breast lump is benign or malignant. Do not use herbs, massage, gua sha or topical products over a new unexplained lump as a substitute for medical assessment.

When not to wait

Seek prompt medical review for a new persistent lump, bloody nipple discharge, major skin/nipple change, rapidly increasing swelling or breast redness with fever.

CHAPTER 7

Cervical Screening and HPV: Why Screening Still Matters When You Feel Well

Cervical screening looks for high-risk HPV or cell changes before cancer develops. Learn how it fits into Singapore preventive care.

Key points

HPV is common; a positive high-risk HPV test is not the same as a cancer diagnosis.

Vaccination lowers risk but does not remove the need for recommended screening.

Bleeding after sex or unusual bleeding is a symptom and should be medically assessed rather than waiting for routine screening.

Why this deserves attention

Cervical cancer is strongly linked with persistent infection by certain high-risk types of human papillomavirus (HPV). Screening is valuable because pre-cancerous changes usually do not cause symptoms. Depending on age and current Singapore recommendations, screening may use a Pap test or HPV test.

What makes it more important

A clinician can explain what an abnormal test means and whether repeat testing, colposcopy or other follow-up is needed. Do not interpret a positive HPV result as evidence of recent infidelity; infection can remain undetected for long periods.

What to do next

Eligible women can access cervical cancer screening under Healthier SG Screening. Check the current official recommendation rather than relying on an old schedule because test type and interval can differ by age and previous results.

Where TCM may fit

TCM should not be used to “clear HPV” or treat abnormal cervical cells without appropriate medical follow-up. Herbal or vaginal products can also interfere with local irritation and should be disclosed before procedures.

When not to wait

Seek medical review for unexplained bleeding between periods, bleeding after sex, postmenopausal bleeding, persistent unusual discharge or pelvic pain.

References & Further Reading

Singapore Ministry of Health — Screening Test Review Committee 2026

HealthHub / Healthier SG Screening

HealthHub public education on stroke, chronic kidney disease and screening