Timeline for Developing Guidelines on Next Generation Sequencing and Potential of Sequencing as Screening Tool

Mr Yip Hon Weng asked the Minister for Health (a) what is the Ministry's timeline for developing guidelines on Next Generation Sequencing (NGS) for treating cancer; (b) whether studies have been conducted on its potential as a screening tool and its cost-effectiveness and included lessons learnt from other countries' experiences; (c) whether there are plans for wider NGS implementation as a diagnostic and treatment tool; and (d) if so, whether Medisave will eventually cover NGS.

Next Generation Sequencing (NGS) is a tool for genetic sequencing. There are two types of NGS: small panel NGS sequences specific segments of genes of interest, while large panel NGS analyses extensive portions or the entirety of an individual's genetic code.

Specifically, for cancers, NGS can be used to identify the makeup of genetic changes in a patient's tumour, for more targeted treatment. That said, for most patients, standard cancer treatments are effective. For certain cancers and patients, our public healthcare institutions use small panel NGS routinely for tumour profiling and such tests could be covered by MediSave and MediShield Life. Our clinicians are guided by international best practices on the most appropriate and best usage of NGS.

For cancers where there is insufficient evidence for routine testing, large-panel NGS is currently used in Singapore as a research tool in clinical trials, to gather evidence on which cancer gene mutations may be more susceptible to which treatments.

As this is an evolving field, there is an ongoing effort by the Ministry of Health to review emerging evidence and developing guidelines for use cases where the deployment of NGS is appropriate as well as clinically- and cost-effective.