Breast cancer is when abnormal cells in the breast start to grow and divide without control. It is the commonest cancer amongst women worldwide. In Malta, around 300 women are diagnosed with breast cancer each year.
The National Breast Screening Programme was established in 2010 and follows the European guidelines on breast cancer screening and diagnosis. The aim of breast screening is to find breast cancers early, when the cancer is too small to be felt either by the woman herself or by a doctor. Women from the ages of 50 to 69 years old and who have no symptoms of breast cancer are invited to attend for a screening mammogram. If the screening mammogram is normal, the woman will be called again in the next screening round. Sometimes further investigations are required, and a breast biopsy can be also taken. If there is a cancer diagnosis, then the woman will be referred to secondary care for more specialised treatment.
It is very important that women, from a young age are well informed and educated on the importance of regular breast self- examination, on the possible signs of breast cancer, such as a lump in the breast, an inverted nipple, a discharge from the nipple or any change in form and size of the breast. Although a small percentage of breast cancer is linked to one’s family history of breast cancer, there are certain modifiable risk factors linked to a possible decreased risk of breast cancer, occurrence – to mention a few – regular physical activity, having a healthy dietary intake of fruits and vegetables, limiting alcohol intake, and having a healthy weight especially after menopause.
Cervical cancer screening
Cervical cancer screening also known as smear/pap test, is a test for diagnosing cervical abnormalities. It is a test to check the health of the cervix, which is the lower part of the womb (often called the neck of the womb). For many women, the test results show that everything is fine. But for around one in 20 women, the test shows changes in cells. These changes are caused by the presence of the human papillomavirus (HPV). HPV is the most common sexually transmitted infection with around 80% being infected at some point in their life. There are many types of HPV, and only a few may cause abnormalities in the cervix. Most of these changes will not lead to cervical cancer and will clear by time. However, some high-grade changes may lead to cancer. The good news about screening regularly is that early detection of cervical abnormalities can be treated. This may lower the risk of cancer developing. Early detection and treatment can prevent around 75% of cervical cancers developing when treatment is more likely to be effective.
Screening test used is a smear/pap test where cervical cells are taken by using a brush like device. These are then sent to a lab in a container and are examined under a microscope. For women above 30 years cervical screening may include testing for HPV. Women with abnormal smear result are either advised to re screen after some months or referred for a colposcopy. This procedure is carried out by a specialist and a biopsy is taken to determine further management.
International research shows that women with increased risk for developing cervical cancer may include, tobacco smokers, having multiple lifetime partners, having sex at a younger age, not screening regularly and women with low immunity (immunosuppressed) conditions.
Cervical cancer may be prevented by screening regularly, refrain from tobacco smoking, limiting lifetime partners and using protection (condoms) and getting HPV vaccine. Currently the National Immunization Services within the Primary Health Care is vaccinating children at 12 years of age.
Colon cancer screening
Colon cancer is one of the most common forms of cancer in Malta, and around 110 people die each year from the disease in the Maltese islands. Colorectal cancer is a type of malignant tumour that occurs in the large intestine. Benign tumours of the colon are usually polyps, which over time; these polyps can develop into cancer. Colorectal screening can detect colorectal cancer at an early stage when it is easier to treat. It can also detect and treat polyps (small growths in the intestine) which can turn into cancer over time. In addition, colon cancer screening helps find cancer early, making a cure more likely. Getting regular check-ups and colon cancer screening is the best way to prevent colorectal cancer. Finding and removing colon polyps helps prevent colon cancer.
The Programme was phased in gradually to help ensure that health services, such as colonoscopy and treatment services can meet any increased demand. The screening programme is increasing to accommodate more clients. Research shows that the risk of colorectal carcinoma increases after the age of 50. Colorectal Cancer Screening is currently offered to all individuals who are between 55 to 74 years of age. Persons in this age group are regularly invited to do a home-testing kit FIT.
There are no risks to your health from the home testing kit. A screening test is used to look for a disease when a person does not have symptoms. This is an easy-to-follow home test with set of instructions. No screening test is 100% reliable. There is a chance that cancer could be missed, meaning you might be falsely reassured. There is also a small risk that the colonoscopy and some of the tests you might have if screening finds something unusual could damage your bowel, but this is rare.
By Permanent Secretary, Ministry for Health Joseph Chetcuti