Why do we screen for disease in the first place?
Health screening is about looking for early signs of disease before you feel unwell, with the aim of changing the course of that disease for the better. A good screening test should not simply throw up “abnormalities” on a report; it should help us prevent strokes and heart attacks, pick up cancers at an earlier stage, protect your kidneys, and reduce the risk of serious complications. In other words, the goal is not just to find things, but to make a real difference to your future health.
This sounds obvious, but it is easy to lose sight of in an era of long test menus, bundled packages and glossy marketing. Not every possible test is helpful, and more testing is not always better. As a family physician, my job is to help you choose the right tests, at the right time, for the right reasons – and just as importantly, to explain why some tests are not necessary for you.
What makes a “good” screening test?
When I recommend a screening test, I am not starting from a blank slate or a package list. I am thinking through a few key questions in the background. Is this condition common enough or serious enough that it makes sense to look for it before symptoms appear? If we pick it up earlier, do we actually change the outcome, or are we simply giving you a label sooner? If we do find something, is there a clear and effective treatment or follow-up that will help you live longer or better? And finally, is the test reasonably accurate, safe, and acceptable to most people?
If the honest answer to these questions is “yes”, the test is more likely to be useful. If not, then even a sophisticated test can end up causing more harm than good – for example, by generating unnecessary worry, leading to repeated scans or biopsies, or prompting treatment of tiny abnormalities that would never have troubled you in real life.
Sensitivity, specificity, and why screening often feels “noisy”
You may sometimes hear doctors talk about a test being “sensitive” or “specific”. These are technical terms, but the ideas are quite simple. A sensitive test is good at picking up a condition when it is present; it casts a wide net, so it misses very few true cases. The trade-off is that it may also catch some people who do not have the disease. A specific test is better at confirming the diagnosis and ruling out people who are actually well.
For screening, we usually start with a more sensitive test. We would rather deal with a few false alarms, which we then check properly, than miss a serious disease altogether. That is why screening often happens in two stages: first, a broader test such as a blood test, a stool test, a mammogram or a simple imaging scan; then, if something looks abnormal, a second round of more focused, more specific tests.
From your perspective, this means that an “abnormal” screening result does not automatically mean you have a disease. It means there is something we should take seriously, interpret in context, and, if needed, confirm or clarify with further tests. The next step is usually calm, careful thinking – not panic.
Why your doctor sometimes repeats an abnormal result
Blood results can fluctuate. Stress, poor sleep, recent exercise, a heavy meal the night before, mild dehydration and even lab variation can all nudge some values up or down. A mildly raised fasting blood sugar, a borderline kidney function, or a slightly abnormal liver enzyme may occasionally be a transient blip rather than a true, stable problem.
This is why I sometimes recommend repeating a test rather than immediately labelling you with diabetes, chronic kidney disease or liver disease on the basis of a single borderline reading. Repeating a test is not “doing nothing”; it is a deliberate step to avoid misdiagnosis and unnecessary anxiety. On the other hand, if a result is clearly abnormal or worrying, we should not ignore it. In those situations, we would discuss further investigations or referral without delay.
Why screening should not be one-size-fits-all
No two people carry exactly the same health risks. When we plan screening, I am thinking about your age and sex, your personal medical history, your family history of heart disease or cancer, your lifestyle – including smoking, alcohol, physical activity and diet – your previous test results, your existing conditions, and even where you grew up or worked.
Singapore is an international city. Many of my patients have lived in several countries or recently moved here from elsewhere in Asia, Europe, Australia or the Americas. Patterns of illness can differ between regions: the likelihood of certain infections, genetic conditions or cancers may be higher or lower depending on where you have spent most of your life. A patient who grew up in another part of the world may need a slightly different screening approach compared to someone born and raised in Singapore.
In practice, I use local guidelines and international evidence as a framework, but I apply them to your specific background and concerns. The result is a screening plan that is individualised, rather than simply ticking every box on a generic list.
Corporate “packages” and their limitations
Many people first meet the idea of health screening through a corporate package or a promotional check-up. These can be convenient, and some include genuinely useful tests. But they are usually designed as “one-size-fits-all” bundles rather than tailored plans. They may include low-value tests for you, and at the same time omit other assessments that would actually matter more in your situation. And they rarely come with a slow, unhurried conversation about your history, your worries and your long-term goals.
The larger risk is that such packages can give the wrong message in both directions. A “normal” package can create a sense of false reassurance, especially if important risk factors – such as your long-term cardiovascular risk, your mental health, your family history, or sleep and stress issues – have not really been explored. On the other hand, an over-enthusiastic package with many niche tests can throw up small incidental findings that trigger a chain of follow-up scans, procedures and worry, without improving your long-term outcome.
This does not mean that corporate screening is automatically bad. It means that, on its own, it is incomplete. The most important step is still to sit down with a trusted doctor who can put those numbers into context and help you decide what, if anything, needs to happen next.
The role of a Family Physician in health screening
As a Family Physician, I do not see health screening as a one-off event that ends when you receive your report. I see it as part of an ongoing relationship.
A typical screening consultation begins before any tests are ordered. I start by asking what you are hoping to achieve: are you mainly looking for peace of mind, early detection of particular conditions because of your family history, assessment before a new phase of life such as pregnancy or a demanding new job, or a more general “health reset”? We then go through your personal and family history in detail – past illnesses, medications, lifestyle, mental health, previous abnormal results – and consider what these mean for your risk profile.
From there, I recommend tests that have good evidence for someone like you, and I will explain why I am not ordering certain other tests that may be fashionable but irrelevant or low-yield in your case. We talk openly about what the possible outcomes of each test might be, and how we would act differently if the result is clearly normal, borderline, or abnormal. Finally, we plan follow-up to review the report together, rather than just emailing you a stack of numbers.
In other words, the conversation should come before, during and after the tests – not only at the end.
Making sense of the report
When your results are ready, the real work is in interpretation. A lab report on its own is just one part of the picture. When we sit down to go through it, I look at where each value sits relative to the reference range, but also how it compares with your previous results, how it fits with your symptoms (or lack of symptoms) and examination findings, and whether any abnormalities translate into real-world risk for you or are simply expected variation.
Sometimes the outcome is reassuring: everything looks appropriate for your age and background, and we simply agree on when to review again. Sometimes the results highlight areas where changes in diet, physical activity, sleep, stress or smoking can significantly reduce your long-term risk of heart disease, stroke, diabetes or kidney disease. Occasionally, we pick up conditions that need timely treatment or specialist input. The key point is that screening is not just about detecting problems; it is about making informed, thoughtful decisions together.
Is health screening right for you now?
If you are wondering whether you should go for health screening, or you have already done a package and are now staring at a report you do not fully understand, it may be helpful to sit down with a Family Physician and talk it through properly.
We can explore what you are most concerned about, which tests are genuinely useful for you at this stage of life, what we will actually do differently if a result is abnormal – and just as importantly, what it means if everything comes back within range. We can then use that information to build a practical plan that feels sustainable, rather than a one-time exercise that leaves you more confused than before.
Screening should give you clarity and direction, not confusion or fear.
Book your health screening consultation
At Kenneth Tan Medical Clinic, we offer personalised health screening that is grounded in evidence and centred on your needs. Whether you are a long-term Singapore resident, an expatriate, or newly arrived from another country, we can help you design a screening plan that makes sense for you and walk you through your results in a clear and calm way.
If you would like to discuss your options, or you already have a report and are unsure what it really means, we would be happy to see you.
Book Your Appointment Online or call us at 6920 1952 to discuss your screening options and results with one of our doctors.