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Colorectal Screening Programme

National Colorectal Cancer Screening Programme - CRSP 
 
Colon cancer is one of the most common forms of cancer in Malta, and around 100 Maltese die each year from the disease. Colorectal cancer can be treated successfully if detected in its early stages, but currently less than 40 per cent of Colon cancers are detected early.
 
In November 2012 the Ministry of Health, Elderly and Community Care launched the National Colorectal Cancer Screening Programme by inviting around 15,000 Maltese each year who turn 60 to 64 years of age between 1 January 2013 and 31 December 2014 to undergo colon screening. The launch coincided with the start of the Breast Screening Programme three years previous. The systems were planned to make use and build on established infrastructures and IT systems.
 
The Programme was phased in gradually to help ensure that health services, such as colonoscopy and treatment services can meet any increased demand. This incremental launch is consistent with the introduction of other screening programs, such as the National Breast Screening Program, which was also phased in incrementally.
 
People from Malta and Gozo eligible to participate in the Programme should receive an invitation through the mail to complete a simple test called a faecal occult blood test (FOBT, detecting tiny traces of blood in the faeces) in the privacy of their own home and mail it to the Lascaris address provided for subsequent analysis. There is no cost involved in completing the FOBT or postage. These screening tests (particularly the FOBi or immuno-based faecal occult blood test) have been shown in clinical trials and established Screening Programs to be simple to use and highly effective.
 
Click here to view the guidelines on how to utilise the Faecal Occult Blood Test.
 
Participants with a positive FOBi result will be contacted and advised to discuss the result with the specialist staff at the Screening Centre, or if they wish with their doctor. These will generally refer them for further investigations, usually a colonoscopy.
 
An ‘immunochemical FOBi’ test has been selected as the preferred testing method for the Malta program, in contrast to the guaiac FOBT used in other centres, as it has no restrictions on diet or medication.

Who will be invited to take part ?

 
People who are within the eligible population will be invited to take part in the Program. The current eligible population for Malta are those turning 60 to 64 years of age between 1 January 2013 and 31 December 2014, who hold a National ID card and registered on one of the datasets mentioned in this page (see invitations). Selection (as for breast screening) is performed by computer based systems - strictly on date of birth (i.e. those born between 1949 and 1953, starting with the older age group. The first invitation cycle will be completed in two years and it is anticipated that after this the age range will be widened to include a wide age group. In January 2015 those tested in the first cycle will be reinvited for a second test – provided they are still within the eligible age group.
 
Temporary ID holders or temporary residents will not normally be invited to participate in the Programme regardless of whether they are in the specified age range. To date, only the faecal occult blood test (FOBT) for men and women aged 50–74 years has been recommended by the EU for colorectal screening.

Why are only people turning 60-64 years of age invited to take part ?

 
Research shows that the risk of developing colorectal cancer rises significantly from the age of 50.
 
It is important that the screening Programme be introduced slowly to provide time to ensure that health services, such as colonoscopy services, are able to meet any increased demand. That is why only those turning 60-64 years of age between January 2013 and December 2014 are being invited to screen.

What is the screening process ?

 
People eligible to participate in the Programme will receive a pre-invitation letter followed by an invitation pack, including an information booklet and an FOBi kit (immuno occult blood in the faeces test), in the mail. Those who choose to participate will complete the FOBi. They will be provided with a preaddressed envelope to send the completed kit to Lascaris or the Screening hub in Gozo:
 
National Screening Programme Co-ordinator
17 Lascaris Wharf
Valletta VLT 1921
MALTA
 
Gozo residents may send their FOBi kit to: - or to the above address
National Screening Programme Co-ordinator
Gozo General Hospital
Medical Laboratory Services
Victoria VCT 102
GOZO
 
Can I bring the kit in person?
 
This may be possible provided you first ring the hub contact – for Malta 21227470, for Gozo 2210628 or 22106203 and confirm this is possible within working hours.
 
The received kit will be logged as received, and taken by the Lascaris Staff to a pathology laboratory, where the test will be analysed.
 
Programme participants will be encouraged to nominate their usual GP or medical practice on their Participant Details Form, but this will not be compulsory. The result of the test will be sent to the participant, their GP (if nominated) and the Programme Register. The FOBT result sent to nominated GPs or practices will include full contact details for the participant.
 
Participants with a positive FOBi may wish to see their GP to discuss the result and usual referral procedures for follow up tests, such as a colonoscopy. Nominated GPs or practices may also receive reminder letters advising them that, according to the information held by the Screening Programme, the participant has not followed up their positive FOBi result with their GP or attended for a colonoscopy or other Colorectal examination. Some people may be asked to repeat the FOBi test.
 
A person with a positive FOBT is 12 to 40 times more likely to have colorectal cancer than a person with a negative test. It is therefore essential that any positive FOBT is appropriately investigated. To ensure that all Programme participants with a positive FOBT result receive adequate follow up, Programme Coordinators will monitor the progress and results for each invitee. Screening Programme Coordinators may contact health professionals and their patients with a positive FOBT result to assist and encourage progression through the screening pathway.
 
Not all positive FOBi test are due to cancer, approximately less than half will not be. Detecting benign lesions such as polyps is equally important since simple removal via colonoscopy may forestall their subsequent transformation into a bowel cancer. One of the aims of the Screening programme is the detection and elimination of benign (non-cancerous) polyps. This alone will greatly impact on the future incidence of colorectal cancer.
 
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Address for the Colorectal screening Programme:
National Cancer Screening Programme
17 Lascaris Wharf
Valletta VLT 1921
MALTA
 
Internet address: www.bowelscreening.gov.mt 
 
This is the same address as the Breast Screening Centre. New premises are being refurbished at 25 Lascaris Wharf, Valletta and will be completed in early 2013. Mail or kits addressed to either address will be accepted and processed.