编者按：由中国抗癌协会主办，天津医科大学肿瘤医院、天津市抗癌协会、中国整合医学发展战略研究院承办的“2023中国整合肿瘤学大会（2023 CCHIO）”将于2023年11月16—19日在天津举办。新加坡国立癌症中心首席执行官William Hwang Ying Khee教授将在本次大会上带来题为“新加坡癌症医疗中的人口健康（Towards Population Health in Cancer Care in Singapore）”的演讲。《肿瘤瞭望》在大会前夕采访了William Hwang Ying Khee教授，分享更多有关新加坡癌症诊疗现状和经验等相关问题。

 

2023 Chinese Congress of Holistic integrative Oncology(2023 CCHIO)will be held in Tianjin from November 16 to 19，2023.Professor William Hwang Ying Khee，who is the Senior Consultant＆Chief Executive Officer of ational Cancer Centre Singapore，will deliver a speech(Towards Population Health in Cancer Care in Singapore)at this congress.He was interviewed by Oncology Frontier on the eve of 2023 CCHIO.

 

 

Oncology Frontier:Could you please introduce the current status and towards Population Health in Cancer Care in Singapore?

 

William Hwang Ying Khee：感谢邀请我参加这次采访，很高兴有机会参加2023 CCHIO大会，并与所有参与者分享我的经验。

 

在新加坡，我们仍然致力于促进癌症诊疗中的人口健康。新加坡癌症诊疗背景下的人口健康将涉及一系列战略和举措，以解决癌症预防、早期检测、治疗和支持癌症患者的问题。

 

癌症是新加坡的主要死亡原因，占所有死亡人数的28%以上。因此，针对癌症的医疗保健政策极为重要。虽然健康的生活方式和预防措施可以降低心脏病和卒中等疾病的发病率，但癌症是随着年龄增长而累积的基因突变的结果。癌症病例的高比例可能是因为我们的人口正在老龄化。事实上，新加坡的平均预期寿命是世界上最高的国家之一（83.7岁，世界银行2020年数据），但这也意味着与衰老相关的癌症多年来一直在增加。

 

随着癌症治疗的巨大进步，多年来癌症患者的存活率大大提高。癌症患者的数量也将继续增加，因为我们有许多好的新疗法，可以显著延长患者的生命。

 

癌症预防仍然是我们战略的基石。新加坡开展了公共卫生运动，以提高对风险因素的认识，并鼓励更健康的生活方式，以减少癌症负担。我们还实施了各种癌症筛查项目，这些项目可能会让一些癌症在仍可治愈的早期阶段被发现。一些常见癌症筛查的改进也使许多人得到了更早的发现和更及时的治疗。

 

William Hwang Ying Khee：Thank you for inviting me to this interview and I am delighted to have the opportunity to participate in the CCHIO 2023 program and share my experience with all participants.

 

In Singapore，we remain committed to advancing population health in cancer care.Population health in the context of cancer care in Singapore would involve a range of strategies and initiatives to address cancer prevention，early detection，treatment，and support for cancer patients.

 

Cancer is the leading cause of death in Singapore，accounting for over 28%of all deaths.As such healthcare policies for cancer are extremely important.While a healthy lifestyle and preventive measures can reduce the incidence of diseases like heart disease and stroke，cancer is a consequence of accumulated genetic mutations as we grow older.The high percentage of cancer cases could be because our population is growing older.In fact，the average life expectancy in Singapore is one of the highest in the world(83.7 years，data in 2020 from the World Bank)，but this also means that ageing-related cancer has been increasing over the years.

 

With vast advancements in cancer treatments，survival rates for people with cancer have greatly improved over the years.The number of persons living with cancer will also continue to increase as we have many good new treatments that can significantly prolong the lives of patients.

 

Cancer prevention remains a cornerstone of our strategy.Singapore has implemented public health campaigns to raise awareness of risk factors and to encourage a healthier lifestyle to reduce the cancer burden.We have also implemented various cancer screening programs，and these programs may allow some cancers to be detected in their early stages when they are still curable.Improvements in screening for some of the common cancers have also led to earlier detection and therefore more timely treatment for many people.

 

 

Oncology Frontier:Do you think there are any Singapore or NCCS models that could be shared globally in cancer diagnosis，treatment，and research?

 

William Hwang Ying Khee：新加坡持续探索许多新政策，以应对癌症大流行。我们不断借鉴中国、美国、日本、欧洲等其他国家和地区的经验和研究成果。与此同时，新加坡继续与全球癌症护理机构合作，促进知识交流和最佳实践的实施。因为新加坡很小，所以我们能够非常迅速地实施许多新政策。

 

我们已经了解到，改变人们对癌症筛查的态度和看法非常重要。有很多人不想去筛查，因为他们不想知道自己是否患有癌症。这是一种“缩头乌龟”思维方式——因此，他们被诊断出患有本可以更早发现的晚期癌症。我们需要做更多的工作来提高公众意识。

 

新加坡坚持以患者为中心的癌症诊疗。我们不仅提供先进的医疗服务，还提供心理支持、姑息治疗和支持治疗，以确保患者及其家人的健康。此外，我们还与政府和保险公司密切合作，确保所有新加坡人都能负担得起和获得医疗保健服务。

 

William Hwang Ying Khee：Singapore continues to experiment with many new policies to deal with the cancer pandemic.We are constantly drawing from the experience and research findings from other countries and regions，such as China，the United States，Japan and Europe.At the same time，Singapore continues to engage in collaborations with global cancer care institutions，fostering knowledge exchange and the implementation of best practices.Because Singapore is small，we are able to implement many new policies very quickly.

 

We have learned that it is important to change people’s attitudes and perceptions of cancer screening.There are many who do not want to go for screening because they do not want to know if they have cancer.This is a kind of缩头乌龟way of thinking–and，consequently，they get diagnosed with late-stage cancer that could have been picked up earlier.We need to do more to raise public awareness.

 

Cancer care in Singapore is centred on the patient.We provide not only advanced medical treatments but also psychosocial support，palliative care，and support groups to ensure the well-being of our patients and their families.In addition，we work closely with the government and insurers to maintain healthcare affordability and accessibility to all Singaporeans.

 

 

Oncology Frontier:You are an expert in hematological tumors.How do you view the development and improvement of new therapies such as CAR-T?

 

William Hwang Ying Khee：很高兴看到在过去近20年的时间里有这么多新的突破和发展。当我在20世纪90年代刚开始接受血液学培训时，许多血液肿瘤患者的平均生存期仅为两年或更短。然而，近年来，随着各种新疗法的出现，这种情况有了相当大的改善。新型小分子抑制剂、单克隆抗体、生物标志物物以及许多新的靶向药物和治疗方法，极大地提高了癌症患者的生存率和生活质量。CAR-T细胞已经彻底改变了肿瘤学，通过使用免疫细胞作为“活药物”来对抗肿瘤，为耐药的肿瘤患者提供了生存的机会。我们只需要通过改进细胞工程和更好的制造技术，找到使这些疗法更具成本效益的方法。

 

William Hwang Ying Khee：It is great to see that there have been so many new breakthroughs and developments in the last 20 years or so.When I first started training in hematology in the 1990s，the average survival of many patients with blood cancer was two years or less.In recent years，however，this situation has improved considerably with the advent of new therapies of all kinds.Novel small molecule inhibitors，monoclonal antibodies，biomarkers，and many new targeted drugs and therapies have greatly improved the survival rate as well as the quality of life of cancer patients.CAR T cells have revolutionized oncology by giving patients with resistant cancer a chance at survival using immune cells that act‘living drugs’to fight cancer.We just need to find ways to make these therapies more cost-effective with improvements in the engineering of the cells and better manufacturing techniques.

 

 

Oncology Frontier:Would you like to say something to CACA and CCHIO’s participants?

 

William Hwang Ying Khee：首先，我要感谢主办方邀请我参加2023年CCHIO大会。我第一次访问中国是在1991年，从那时起，我多次来中国参加会议、商务、培训和休闲活动。在过去的30年里，中国在医疗保健方面的进步和发展是惊人和显著的。中国是世界上人口最多的国家，在过去几十年里，随着医疗保健和生活质量的进步，中国人民的生活得到了显著改善。中国在商业和制造业的许多方面都处于领先地位。新加坡是一个移民小国，许多移民是中国人，是东西方交流的桥梁。由于良好的治理及其人民在全球舞台上取得成功的决心，尽管新加坡的规模很小，但还是取得了进步。我们可以从中国学到很多东西，我们可以一起做很多事情。我希望新中两国在癌症诊疗领域有更多合作机会，共同为患者谋福利。

 

William Hwang Ying Khee：First of all，I would like to thank the organizers for inviting me to participate in CCHIO 2023.My first visit to China was in 1991 and，since then，I have come many times for conferences，business，training，and leisure.The progress and development in medical care in China over the last 30 years are amazing and remarkable.China is the world’s most populous country and it has significantly improved the lives of its people over the last few decades with advances in healthcare and quality of life.It is a leader in many aspects of business and manufacturing.Singapore is a small country of immigrants，many of whom are Chinese，and serves as a bridge between East and West.It has advanced despite its small size due to good governance and the determination of its people to succeed on the global stage.There is so much that we can learn from China and there is so much we can do together.I hope that there will be more opportunities for Singapore and China to cooperate in the field of cancer care and work together for the benefit of patients.