Screening for cervical cancer, which will start being offered towards the end of this year, is planning to target 35,000 women by 2019.
The programme will be fully operational in 2016 and the plan is to start screening women aged between 25 and 35, Health Parliamentary Secretary Chris Fearne said when contacted.
This follows on the success of the breast and colon cancer screening programmes – introduced in 2009 and 2012, respectively.
Nearly 40,000 women, of the 70,000 invited, have undergone a mammogram since 2009 – one of the highest acceptance levels in Europe – and 270 cases of cancer that could have progressed if left untreated were detected.
Last year alone, 320 women were screened every week and 47 cancers were detected.
270
- the number of cancer cases detected since 2009
Asked if breast screening outweighed the risk of false positives and unnecessary intervention, Mr Fearne, a paediatric surgeon by profession, acknowledged that false positive results could cause distress and anxiety, but the alternative was to delay treatment and an increased mortality rate.
“Breast cancer is the commonest cancer in women in Malta and caught early enough the survival rate is up to 95 per cent,” he said.
He pointed out that many northern European countries with highly organised screening programmes, which have been ongoing for some 30 years, showed improved mortality figures with the introduction of screening. The colon cancer screening is also doing well and is ahead of its targets: the invitation is now being extended to those aged 55 to 60.
Of the 21,000 adults invited last year, 52 per cent accepted. Of these, 411 tested positive and 20 patients were diagnosed with colorectal cancer. The majority had precancerous polyps (small growths on the lining of the large intestine), which were removed.
The running cost of both screening programmes hits €1 million a year, but Mr Fearne said the savings – both financial, through earlier diagnosis, and in easing human misery by saving lives, far outweighed the costs.
For breast cancer, earlier detection meant the nation’s health system made savings of some 20 per cent or more.
“We estimate that just over a quarter of the current expenditure goes on hospital inpatient costs, not including surgery,” he said.
Mr Fearne explained that 80 per cent of patients screened required one to two days in hospital, and full radiotherapy or chemotherapy was uncommon in those diagnosed through screening.
Total costs can reach between €50,000 and €100,000, so the programme has made treatment savings of some €200,000 for the 270 breast cancer cases diagnosed.
Asked if there was enough participation, Mr Fearne said attendance for women at the second cycle for breast cancer screening was over 80 per cent.
For colon cancer the response rate was about 50 per cent but was rising from month to month. This figure was well above the expected figure other countries experienced at the first cycle.
Malta sees 2,000 new cancer cases per year, the equivalent of a new case every four hours. The disease kills between 700 and 800 people each year.
Mr Fearne is mindful that the incidence of cancer will continue to increase since screening programmes add to the number of cases detected, but mortality figures then start to drop. He believed Malta would start reaping the beneficial effects of screening by 2017.
Asked if Malta had enough resources to cope with the number of cancer cases, Mr Fearne said no country in the world had enough to spend on health and costs rose inexorably year by year.
“Merely dispensing treatments is no longer enough, we want citizens to take ownership of their health and lifestyle and adopt a more proactive approach – one that prevents the onset of illness rather than seeks advice for established disease.”