Projecting Future Cancer Incidence and Costs in Singapore to 2050

Introduction: Singapore’s rapidly ageing population and lifestyle transitions have contributed to a rising cancer burden, placing increasing pressure on healthcare resources. Robust estimates of future cancer incidence and costs are essential to inform national capacity planning, financing strategies, and cancer care policy. Singapore Translational Cancer Consortium (STCC) sanctioned this study to use population estimates and cancer incidence to provide projections of cancer incidence and direct medical costs to the health system through 2050 for the top 15 cancers. Methods: This population-based study used the National Trusted Research and Real-World Data Utilisation and Sharing Tech (TRUST) platform and included 268,189 incident cancer cases diagnosed from 2000-2021 in the Singapore Cancer Registry. Historical incidence trends were estimated using joinpoint regression. Future cancer incidence to 2050 was projected using generalized additive models stratified by age and sex. National medical claims from 2005-2016 were analyzed to estimate first-year and five-year post-diagnosis costs with a minimum follow-up of five years. Generalized linear models (gamma distribution, log link) were used to project per-patient costs, which were multiplied by projected incidence to obtain national-level expenditure till 2050. Results: From 2000 to 2021, cancer cases in Singapore nearly doubled. The age-standardized incidence rate surged from 200.8 to 246.4 per 100,000 in women, while remaining stable in men (232.5 to 235.6 per 100,000). Annual percent increases were 0.88% (95% CI: 0.62-1.21) for women and 0.19% (95% CI: 0.06-0.35) for men. The overall annual cancer incidence is projected to soar 3.3-fold from 2.35 to 7.59 per 1,000 population by 2050. The incidence of cancer in females will increase by 3.5-fold (2.39→8.39 per 1,000), and in males nearly 3-fold (2.30→6.79 per 1,000). Adults aged ≥80 years will account for 37.1% of all cases in 2050, which is three times higher than 13.30% in 2000. Financial impact is large: first-year direct medical costs escalated by approximately three fold from US 104.4 million in 2005 to US 308.5 million in 2016. Five-year cumulative costs rose 3.5 fold from US 150.7 million to US 517.0 million during the same period. By 2050, national expenditure is expected to reach US 1.3 billion for cases in the first year post-diagnosis and US 23.6 billion over five years to the health system. Conclusion: Our study showed that Singapore may face a dramatic escalation in cancer incidence and healthcare costs by 2050. These findings underscore an urgent imperative for early detection, robust prevention strategies, and sustainable financing models to address the mounting clinical and economic burden of cancer. Citation Format: Ian JY Wee, Hui Miao, Dawn Q. Chong, Evelyn YT Wong, Grace Yang, Kelvin Bryan Tan, Cheng Ean Chee, Iain B. Tan. Projecting the future cancer burden in Singapore: National incidence and direct medical cost estimates to 2050 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 3567.