[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-385547-105":59,"doc-detail-385547-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","understanding-cancer-predisposition-in-singapore-whats-next","Understanding cancer predisposition in Singapore - what’s next","","Knowledge of an underlying genetic predisposition to cancer enables personalised prognostic, preventive, and therapeutic strategies for patients, with important clinical implications for family members. Despite progress, six challenging management areas remain, including unexpected germline variants from somatic tumour testing, optimal risk management for moderate-penetrance genes, and the role of polygenic risk scores in under-represented Asian populations. It also addresses VUS management, trials for germline pathogenic variants, and technology in genetic counselling, enabling the next step in precision medicine in Singapore.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/understanding-cancer-predisposition-in-singapore-whats-next/385547/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/understanding-cancer-predisposition-in-singapore-whats-next/385547.png","ImageObject",300,407,{"name":92,"@type":93},"MrHarris58","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-26","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How does knowledge of cancer predisposition genetics affect patient care?","Question",{"text":112,"@type":113},"It supports personalised prognostic, preventive, and therapeutic strategies. It also has clinical implications for family members who may share underlying risk.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What challenges still exist in managing hereditary cancer predisposition syndromes?",{"text":117,"@type":113},"Key challenges include finding unexpected germline variants via somatic tumour testing, optimising risk management for moderate-penetrance genes, using polygenic risk scores in under-represented Asian populations, and managing variants of uncertain significance.",{"name":119,"@type":110,"acceptedAnswer":120},"What is the suggested impact of addressing these barriers in Singapore?",{"text":121,"@type":113},"Overcoming these barriers helps advance precision medicine in Singapore. Empowering healthcare stakeholders with genetic knowledge enables better care and full use of novel genomic insights.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},385547,1790465450,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46},687212988360,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","| Review Article |\n| --- |\n|  |\n\nUnderstanding cancer predisposition in Singapore: what’s next  \nJianbang Chiang1,2, MBBS, MRCP, Tarryn Shaw1, MSc, Joanne Ngeow1,2,3, MBBS, MPH  \n1Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, 2Oncology Academic Clinical Program, Duke‑NUS Medical School,  \n3Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore  \nAbstract  \nKnowledge of an underlying genetic predisposition to cancer allows the use of personalised prognostic, preventive and therapeutic strategies for the patient and carries clinical implications for family members. Despite great progress, we identified six challenging areas in the management of patients with hereditary cancer predisposition syndromes and suggest recommendations to aid in their resolution. These include the potential for finding unexpected germline variants through somatic tumour testing, optimal risk management of patients with hereditary conditions involving moderate‑penetrance genes, role of polygenic risk score in an under‑represented Asian population, management of variants of uncertain significance, clinical trials in patients with germline pathogenic variants and technology in genetic counselling. Addressing these barriers will aid the next step forward in precision medicine in Singapore. All stakeholders in healthcare should be empowered with genetic knowledge to fully leverage the potential of novel genomic insights and implement them to provide better care for our patients.  \nKeywords: Cancer genetics, genetic testing, precision medicine, Singapore  \nINTRODUCTION  \nThe application of germline genetic testing is becoming more common in cancer treatment selection and hereditary cancer risk evaluation and management in Singapore, with a significant increase in the number of cases referred for genetic counselling. [1] This is likely aided by the rising genetics awareness and literacy amongst both healthcare professionals and the Singaporean public,[2] partly as a result of sustained efforts from the genetics community.[3] Cancer has often been dubbed an aberration of the genome. Even with complete sequencing of the human genome in 2003, we have only begun to scratch the surface in understanding the interconnected pathways of carcinogenesis.[4] Multigene assays allow comprehensive genetic analysis at low cost and improve accessibility to germline testing for patients and at‑risk relatives because of more expansive testing criteria. Knowing the sequence is the first step; interpreting the data and translating this into clinical practice is the next major hurdle. As we begin to uncover the multitude of genomic pathways and their role in cancer development, we are beginning to find novel therapeutics with pan‑tumour indications. This heralds the onset of precision medicine, which aims to deliver the right drug to the right patient at the right time.[5]  \n\n| Access this article online |  |\n| --- | --- |\n| Quick Response Code:\u003Cbr>| Website:\u003Cbr>[https://journals.lww.com/SMJ](https://journals.lww.com/SMJ) |\n|  | DOI:\u003Cbr>10.4103/singaporemedj.SMJ‑2021‑468 |\n\nTumour molecular profiling is the bedrock of precision medicine,[6] having originated in the germline arena . Germline and somatic sequencing in the management of cancer can identify pathogenic variants that affect patient management in several ways. Firstly, knowledge of an underlying cancer predisposition syndrome may impact surgical decision. For example, BRCA1/2 pathogenic variant carriers may opt for upfront risk‑reducing bilateral mastectomy and salpingo‑oophorectomy to reduce the lifetime risk of breast and ovarian cancers, respectively. Secondly, clinicians may fine‑tune patient surveillance with prior knowledge of a cancer predisposition syndrome. Asan example, Li‑Fraumeni patients with a TP53 pathogenic variant on surveillance should consider minimising radiation exposure and avoid regular surveillance with computed tomography scans bec","cbCaihl05DSNUJDt","https://ap.wps.com/l/cbCaihl05DSNUJDt","pdf",770291,"English","# Abstract\n# Introduction\n## Germline genetic testing in Singapore\n## Precision medicine and interpretation of genomic data\n## Applications of germline and somatic sequencing","[{\"question\":\"How does knowledge of cancer predisposition genetics affect patient care?\",\"answer\":\"It supports personalised prognostic, preventive, and therapeutic strategies. It also has clinical implications for family members who may share underlying risk.\"},{\"question\":\"What challenges still exist in managing hereditary cancer predisposition syndromes?\",\"answer\":\"Key challenges include finding unexpected germline variants via somatic tumour testing, optimising risk management for moderate-penetrance genes, using polygenic risk scores in under-represented Asian populations, and managing variants of uncertain significance.\"},{\"question\":\"What is the suggested impact of addressing these barriers in Singapore?\",\"answer\":\"Overcoming these barriers helps advance precision medicine in Singapore. Empowering healthcare stakeholders with genetic knowledge enables better care and full use of novel genomic insights.\"}]","Understanding cancer predisposition in Singapore - what’s next | PDF",1790269946]