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The National Health Screening Services Malta administers the National Cancer Screening Register for the Maltese Islands, for Breast Cancer and Colorectal Cancer screening. The Information System or Register issues invitations for Malta and Gozo to participate in the Program, records participants' details including screening history, test results and special investigations, as well as issuing reminder letters to participants and their nominated doctor/medical practice. The National Screening Programme centre in Malta also operates the main Information Line which provides information regarding the Programme to the general public and medical practitioners during business hours, and to access the Programme Co-ordinators, to inform and help encourage participants with a positive result to complete the screening pathway.

Invitations
To send invitations to participate in the Program, National Screening Programme Malta selects invitees from four sources. These include the National Screening Programme enrolment records or Lascaris Administration System dataset, the Common Database (CdB) of Information on Citizen/Person, the Hospitals Patient Administration System (PAS) and the Social Security Benefits Administration System (SABS). Data collection is authorised by the respective Authorities and guided by the Data Protection Act (Chapter 440 of Maltese Law, amended 15th July 2003).
Personal information and test results are kept private and confidential. Information kept on the Lascaris Screening Information System is protected by law and personal details are released in accordance with the Information Privacy Principles of that Act.
 
 
The National Screening Programme Malta's has many roles, including:
• Maintenance of the National Breast and Colorectal Cancer Screening Programme Information System
• Collection of information about participation in the Programme and test results and
• Mailing house functions.
• Quality Assurance information and audit
• Call / recall and fail-safe systems
• Health Education and awareness
 
 
Role of Family Doctors 
 
• Encourage those invitees who are sent a FOBT through the Programme to participate in the Programme. 
• Where necessary review and support those with a positive FOBT once the programme refers them for further examination as clinically indicated, for example, a colonoscopy, or a tissue sample. 
• Inform and guide patients who require further explanation of the findings at investigations such as mammography or colonoscopy, with the help of the Radiographers or Screening Nurses available at Lascaris, or the Colonoscopy Nurses at Mater Dei or Gozo Hospitals.
 
Role of Specialist Services
Specialist services and their submission of data to the Lascaris system play a fundamental role in the screening pathway. Collection of data relating to the participants’ journey through the screening pathway is critical to monitoring and evaluating the impact and outcomes of the Programme.
 
Specialists are asked to: 
• Provide follow-up diagnostic procedures associated with referrals received from the screening programme. 
• Help manage individuals identified as being at high risk of breast and colorectal cancer in accordance with the agreed Clinical Guidelines. 
• Notify the Screening ICT information systems and the Screening Programme Co-ordinators about outcomes, procedures and results utilising the Clinical Reporting tools.
 
Specialist services and their submission of data to the Lascaris system play a fundamental role in the screening pathway. Collection of data relating to Programme participants’ journey through the screening pathway is critical to monitoring and evaluating the impact and outcomes of the Program.
 
Role of Radiographers, Screening Nurses and Colonoscopy Nurses
Screening nurses or radiographers who specialise in mammography will be available for telephone consultations at the Lascaris Centre, with dedicated telephone lines. They will help advice invitees and handle queries regarding their test including FOBi, ultrasound or mammogram, or any issues which may arise from use of any test and its dispatch to the Centre for processing. Family doctors may also wish to direct any enquires to these offices to determine clinical information on outcomes of further appointments. Subjects who undergo colon screening and are referred for Colonoscopy or other investigations specialised Colonoscopy nurses have been appointed at Mater Dei Hospital and Gozo General Hospital to cater with enquiries on aspects of this investigation.
 
Role of Programme Staff at Screening Centre, Lascaris Wharf
Screening Co-ordinators will oversee and monitor the client screening process. Each invitee will be checked for correct address and contact details and receipt of invitation or test kit. The subsequent pathway will differ according to the test results and the patient itinerary will be recorded in the Lascaris systems until completion of the screening event. This will ensure that further recalls are triggered by computer - according to the test results. Screening co-ordinators should be seen as key workers particularly in recording the client journey and ensuring call/recall is updated.
Enquiries regarding the screening process on individual clients can be first directed to the screening coordinators who will help resolve appointments or issues with tests or consult with Hospital staff for those undergoing surgery or further tests such as colonoscopy.
 
The multidisciplinary team
 
Breast Screening
 
Any woman who has been recalled for a tissue sample or biopsy will be discussed at the weekly multidisciplinary team meeting. Whenever breast cancer is confirmed by a biopsy, careful analysis of the findings is performed jointly by the imaging, surgical and oncology expert teams to determine the best approach. Some women may require extra surveillance with more regular X-ray mammography.
 
Colorectal Screening
 
Patients who have polyps detected at colonoscopy need careful evaluation and a treatment plan, depending on the nature of the polyp – even when this is entirely cancer free. Polyps and other lesions detected at colon screening are normally reviewed at the weekly Multidisciplinary Team meeting.
Likewise, when cancerous growths are found during optical colonoscopy, small tissue samples (biopsies) can be obtained and examined under the microscope to determine the nature of the cancerous growth seen on the microscope within the polyp. Whenever colon cancer is confirmed by a biopsy, careful analysis of the findings is performed jointly by the colonoscopy, imaging, surgical and oncology expert teams to determine the best approach at the multidisciplinary meeting.
In some instances staging examinations are performed to determine whether the cancer has already spread to other organs. Since colorectal cancer tends to spread to the lungs and the liver, staging tests usually include CT scans of the lungs, liver, and abdomen. This is an uncommon event in many of the early cancers detected at screening.
 
More Information
For more information about the National Cancer Screening Programme visit the Department of Health Website or request a booklet by writing to us.
 
For more information about the National Colorectal or Breast Cancer Screening Programme Register and additional Programme materials, you can call the:
National Cancer Screening Programme Information Line in Malta on 21227470, 21227471
 
For enquiries regarding the correct procedures for completion of FOBi kits (immuno faecal occult blood-faeces test),
Malta ring 21227470, 21227471
for FOBi Kit returns to Gozo ring 21561600, 22106384
Further lines will be available in early 2013