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