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maltatoday | SUNDAY • 19 NOVEMBER 2023 THIS IS A PAID COLLABORATION Breast Screening Breast cancer is when abnormal cells in the breast start to grow and divide with- out 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 Pro- gramme 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 invit- ed to attend for a screening mammo- gram. 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 ed- ucated 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 dis- charge 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 diagnos- ing 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 wom- en, 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 infect- ed 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 cer- vical abnormalities can be treated. This may lower the risk of cancer developing. Early detection and treatment can pre- vent around 75% of cervical cancers de- veloping 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 develop- ing cervical cancer may include, tobacco smokers, having multiple lifetime part- ners, 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 Im- munization Services within the Primary Health Care is vaccinating children at 12 years of age. Colon Cancer Screening Colon cancer is one of the most com- mon 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 usual- ly polyps, which over time; these pol- yps 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 reg- ular check-ups and colon cancer screen- ing is the best way to prevent colorectal cancer. Finding and removing colon pol- yps helps prevent colon cancer. The Programme was phased in gradu- ally to help ensure that health services, such as colonoscopy and treatment ser- vices can meet any increased demand. The screening programme is increas- ing to accommodate more clients. Re- search shows that the risk of colorectal carcinoma increases after the age of 50. Colorectal Cancer Screening is current- ly offered to all individuals who are be- tween 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 per- son 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. Malta's commitment to early cancer detection By Joseph Chetcuti - Permanent Secretary, Ministry for Health