Singapore, 20 October 2026 — Friends may play a direct role in whether people keep up with cancer screening regularly, while family influence appears to operate more through knowledge and attitudes towards screening, according to new research by Singapore Management University’s (SMU) Centre for Research on Successful Ageing (ROSA).
ROSA’s new study, Who encourages screening? Examining family, friendship and other drivers of health screening participation in later life, highlighted different ways in which family and friends could support screening, from building knowledge to encouraging engagement with preventive health programmes.
The study analysed data from 7139 Singapore Life Panel®, participants aged 50 to 79, examining whether they reported regular cervical, colorectal and breast cancer screening at intervals consistent with recommended guidelines. Friendship networks were found to be directly associated with regular screening for breast, cervical and colorectal cancer in most of the groups examined, while family influence appeared to operate more through knowledge and attitudes towards screening.
The study also found that enrolment in Healthier SG was associated with more regular cancer screening. Together, the findings suggest that efforts to improve participation in preventive health programmes may need to take account not only of access, knowledge and individual attitudes, but also of the social environments in which people make health decisions.
Professor Paulin Straughan, Director of ROSA said: “Older adults have different needs and circumstances, and our findings reflected that. Understanding those differences can help us move beyond a uniform approach to encouraging screening. Future efforts can build on the support available to each person and address gaps that may make regular screening harder to sustain.”
Key findings and practical implications for society:
Social networks may help people engage with Healthier SG, supporting more regular cancer screening.
Healthier SG enrolment was associated with more regular cancer screening. The influence of friends may support this pathway by encouraging Healthier SG enrolment. This pattern was observed for all cancer screening with one exception (colorectal screening among those aged 50–59).
This suggests that national healthcare programs do not always operate independently of people's social environments. Interventions should promote the establishment of supportive non-kin relationships and networks.
Friends may exert a more direct influence on screening behaviour, whereas family support and norms may function as underlying contextual factors.
The direct association of friends on regular screening was seen in all our findings, except for colorectal screening for those aged 70 to 79 years, and 60 to 69 years. Friends may provide an additional route through which health information, encouragement and screening behaviours spread. This suggests that strengthening community and non-kin networks may help extend the reach of preventive health, especially for those who may have fewer family or socioeconomic resources.
Family remains an important source of influence for regular screening. However, they are more likely to help set the stage for better knowledge about cancer screening, rather than directly associating with screening itself.This is potentially important from a policy perspective. Family circumstances are difficult to change, whereas opportunities for friendship, peer support and community connection can potentially be strengthened through community interventions.
Knowledge and attitudes shape screening, but they can be changed through social and preventive support.
Knowledge about screening and fatalistic beliefs were broadly associated with regular cancer screening. Importantly, these are not entrenched and may be shaped by family, friends and engagement with Healthier SG.
Cancer screening pathways vary across age groups, cancer types and socioeconomic backgrounds.
Those in their 60s showed more pathways that could lead to regular screening. As cancer risk becomes more salient at this age, they could be more responsive to different sources of influence, such as family, friends, or engagement with Healthier SG.
Education level and housing type matter for regular screening, but how they influence screening differs across age groups and cancer types. As these socioeconomic circumstances are difficult to modify, non-kin peer support may provide additional pathways to bridge socioeconomic differences in regular screening.
Improving the regularity of cancer screening may require more than simply providing access to screening services. The social context in which people live can shape their engagement with national health interventions, their knowledge about screening and their sustained screening behaviour.
The study excluded participants with a history of cancer. The analysis used structural equation modelling to examine associations between social influence, knowledge, and Healthier SG enrolment and screening regularity. The research was made possible with The Ngee Ann Kongsi and support from the Ministry of Education.
Click here for the full report.
ROSA Symposium on Successful Ageing: Unlocking the Potential of a Superaged Singapore
Unveiled at SMU’s sixth annual ROSA Symposium on Successful Ageing on 20 October 2026, the study was one of the topics discussed. Themed Unlocking the Potential of a Superaged Singapore, the Symposium analysed how age-friendly environments, preventive health, financial planning and community support can enable successful ageing.
Guest of Honour Ms Indranee Rajah, Minister, Prime Minister’s Office and Second Minister for Finance and National Development delivered the keynote address and participated in the panel discussion “Transforming Longevity into Societal Advantage”, moderated by Professor Paulin Straughan, Director of ROSA.
Close to 200 participants from government, academia and industry attend the Symposium, which served as a platform to facilitate ROSA’s efforts to translate applied research, drawn from its Singapore Life Panel, into evidence-based policy interventions.
The Singapore Life Panel (SLP)
Singapore is officially a super-aged society, with more than 1 in 4 Singaporeans now over the age of 65. ROSA’s applied research aim to shed light on the optimal ways to enhance the well-being of older adults in Singapore and promote successful ageing.
ROSA’s studies are drawn from a rich repository of data known as the Singapore Life Panel®, a national longitudinal survey of Singaporeans that started in 2015. The SLP has an average response rate of about 7,200 respondents per month and is web-based. With the SLP, ROSA undertakes one of the largest high-frequency surveys in the world, collecting data on a monthly basis to understand ageing trends in Singapore.
Housed within SMU, ROSA’s research focuses on addressing areas of pressing societal need and reflects the University’s SMU2030 vision to create meaningful impact and transform lives through education, research and partnerships.
^Population in Brief Report (National Population and Talent Division)