Quick answer. Lung cancer is one of the leading causes of cancer death in Singapore. Smoking is the biggest risk factor, but importantly nearly half of Singapore’s lung cancer patients have never smoked – many of them Asian women – so non-smokers can develop it too. Warning signs include a persistent cough, coughing up blood, breathlessness, chest pain and unexplained weight loss. Low-dose CT (LDCT) screening is recommended for high-risk smokers aged 50-80 with a 20 pack-year history. Treatment has advanced greatly, with targeted therapy and immunotherapy improving outcomes. See a doctor about a cough lasting more than three weeks or any coughing of blood.
Lung cancer remains one of the leading causes of cancer death in Singapore, but the way we understand and treat it has changed dramatically. While smoking is by far the largest risk factor, a striking feature of lung cancer in Singapore and across Asia is that nearly half of patients have never smoked – and many of these are women. This means lung cancer is not only a smoker’s disease.
This guide covers the risk factors, the symptoms worth acting on, who qualifies for screening, and the major treatment advances such as targeted therapy and immunotherapy. It is general information and not a substitute for medical advice. If you have a cough that will not go away, or you cough up blood, please see a doctor.
At a glance
| Aspect | Detail | Note |
|---|---|---|
| Impact | A leading cause of cancer death in Singapore | Outcomes improve markedly with early detection |
| Key risk | Smoking is the #1 risk factor | But ~half of local patients never smoked |
| Non-smokers | Often Asian women; adenocarcinoma is common | Symptoms should be checked regardless of smoking history |
| Screening | LDCT for high-risk smokers aged 50-80 (20 pack-year history) | Not routinely recommended for non-smokers |
| Treatment | Surgery, radiotherapy, chemo, targeted therapy, immunotherapy | Targeted/immunotherapy have improved outcomes |
Lung cancer in Singapore: a disease of smokers and non-smokers
Lung cancer is among the most common causes of cancer death in Singapore. Smoking is the single biggest risk factor, responsible for the majority of cases worldwide. But a notable local and Asia-Pacific pattern is that nearly half of Singapore’s lung cancer patients have never smoked, with adenocarcinoma (a type of lung cancer) being especially common in women and non-smokers. The reasons are still being researched and may include genetic factors, family history, air pollution and other exposures. The practical message: lung cancer can affect anyone, so symptoms should be taken seriously regardless of smoking history.
Risk factors
- Smoking (current or past) – by far the most important risk, including from second-hand smoke
- Family history of lung cancer
- Exposure to radon, asbestos and certain workplace chemicals
- Air pollution and other inhaled carcinogens
- Prior lung disease
Quitting smoking at any age reduces risk and benefits overall health. For non-smokers, no single avoidable cause is usually identifiable, which is why awareness of symptoms is so important.
Symptoms and red flags: when to see a doctor
Early lung cancer may cause no symptoms. See a doctor if you have:
- A persistent cough lasting more than three weeks, or a change in a long-standing cough
- Coughing up blood or blood-stained phlegm (always get this checked)
- Breathlessness or wheezing that is new or worsening
- Chest pain, especially with breathing or coughing
- Unexplained weight loss, fatigue, or repeated chest infections
- Persistent hoarseness
These symptoms are common and usually not cancer, but coughing up blood or a cough that lingers should always be assessed promptly so any serious cause can be found early.
Screening: who should consider LDCT?
Low-dose CT (LDCT) is currently the only recommended screening test for lung cancer, as it can detect small nodules not visible on a chest X-ray. Under Singapore’s 2025 guidelines, LDCT screening is recommended for high-risk individuals aged 50-80 with a 20 pack-year smoking history who currently smoke or quit within the last 15 years. (A 20 pack-year history means, for example, one pack a day for 20 years.)
Screening is not routinely recommended for non-smokers, although research studies in Singapore (such as the NCCS-led SOLSTICE study) are actively exploring whether screening could benefit never-smokers, including those with a family history. If a nodule is found, it is followed up carefully – see our lung nodules guide. If you think you may be high-risk, discuss screening with your doctor.
Diagnosis and staging
If lung cancer is suspected, your doctor may arrange:
- Imaging – chest X-ray, CT, and often a PET-CT scan to assess spread
- Biopsy – taking a tissue sample (via bronchoscopy or needle) to confirm the diagnosis and type
- Molecular and biomarker testing of the tumour, which is now standard and guides modern treatment choices
Staging (from I to IV) describes how far the cancer has spread and shapes the treatment plan. Detecting cancer at an early stage offers the best chance of cure.
Treatment advances: targeted therapy and immunotherapy
Lung cancer treatment has advanced significantly in recent years and is planned by a multidisciplinary team:
- Surgery for early-stage, localised cancers offers the best chance of cure
- Radiotherapy and chemotherapy, used alone or together
- Targeted therapy – tablets that act on specific gene changes (such as EGFR mutations, which are common in Asian non-smokers), often with fewer side effects than chemotherapy
- Immunotherapy – which helps the body’s own immune system fight the cancer
These advances mean that even some advanced lung cancers can now be controlled for much longer, with better quality of life. The right treatment depends on the cancer’s type, stage and molecular profile.
Related guides
- Best Oncology Clinics in Singapore — our editorial shortlist
- oncology clinics directory
- Colorectal (bowel) cancer
- Prostate cancer
- Nasopharyngeal cancer (NPC)
Sources
- NCCS – Lung Cancer Screening
- NCCS – Lung cancer screening should be extended to non-smokers: Expert
- NCCS – SOLSTICE lung cancer screening study (non-smokers)
- HealthHub – Lung Cancer
Related conditions & guides
Related conditions and guides you may find useful:
- Asthma Treatment in Singapore
- Breast Cancer Screening in Singapore
- Breathlessness in Singapore
- Bronchitis in Singapore
- Cancer Screening in Singapore
- Cancer Treatment Cost in Singapore
Part of our Cancer care & screening guides · Browse all health topics