Issue link: https://maltatoday.uberflip.com/i/1534095
2 maltatoday | SUNDAY • 6 APRIL 2025 NEWS CONTINUED FROM PAGE 1 However, despite Malta's progress, the report highlights persistent challenges in prevention efforts, access to innovative can- cer treatments, and healthcare inequalities, particularly affecting lower-income groups and migrants. Malta also reported lower overall can- cer incidence rates compared to other EU countries. The incidence of lung, colorectal, prostate, and breast cancer is notably lower. While the incidence rate among men in Malta is significantly lower (614 per 100,000 when compared to 684 in the EU), the incidence rate among women remains slightly higher than the EU av- erage (494 per 100,000 in Malta com- pared to 488 in EU). The gender gap in cancer incidence is also smaller than the EU average, with 40% more cases among men than wom- en across the EU, compared to a 24% gap in Malta. Uterine and thyroid cancers a concern The decline in colorectal and breast cancer mortality is largely attributed to improved screening and early detec- tion. However, the report stresses that more timely interventions are required to improve colorectal cancer care, par- ticularly among women. While Malta performs well overall, certain cancers remain a concern. The incidence of uterine cancer among women is 33% higher than the EU av- erage, and thyroid cancer incidence is 31% higher. However, lung cancer rates among women are 45% lower than the EU average. Malta has seen a sharp decrease in mastectomies, with the lowest rate of total mastectomies in the EU in 2021. The number of total mastectomies per- formed fell from 130 in 2013 to 67 in 2021, a 58% decline. Partial mastecto- mies also declined by 17% between 2018 and 2021. Childhood cancer incidence rates in Malta are also lower than the EU aver- age (6.8 per 100,000 children compared to 13.7 per 100,000 in the EU). Despite this, childhood cancer mortality in Mal- ta is considerably higher, with an aver- age of 3.4 deaths per 100,000 children, compared to 2.1 in the EU. Malta lags in prevention efforts Despite its low cancer mortality and incidence rates, Malta lags behind in prevention strategies. The report notes that only 1.2% of Malta's health expend- iture is dedicated to prevention – one of the lowest rates in the EU and far be- low the EU average of 6%. The report calculates that Malta can prevent 2,377 cancer cases between now and 2050 if it manages to reach its targets on re- ducing obesity, air pollution, tobacco smoking and alcohol consumption. Obesity a major concern Obesity remains a major concern, with 63% of Maltese adults classified as over- weight or obese. This rate is higher among men (70%) than women (54%), with Malta's female obesity rate nearly a quarter higher than the EU average. The issue is par- ticularly pronounced among women with lower education levels. Childhood obesity is also a pressing issue, with the percentage of overweight adolescents in Malta 48% higher than the EU aver- age. The problem is particularly acute among children from disadvantaged backgrounds, with those in the lowest income bracket being 11 percentage points more likely to be overweight. While smoking rates among adults in Malta have remained stable at around 21% from 2008 to 2019 – unlike other EU countries, which have seen declines – youth smoking rates are among the lowest in the EU, with only 10% of ado- lescents reporting having smoked in the past 30 days in 2022. Gaps in treatment and financial burdens However, access to treatment remains a challenge due to financial constraints. The OECD report referred to the fact that in general Malta has the highest out-of-pocket health expenditure in the EU, with 7.7% of household consump- tion spent on healthcare, more than double the EU average of 3.2%. In 2022, 26% of people reported out- of-pocket payments for non-covered pharmaceutical medications. Moreover, while cancer diagnosis and treatment are largely free under the national health service, patients often have to pay for medicines not listed in the government formulary list, in- cluding many cancer drugs. However, certain oncology medicines not listed on the formulary are still provided by the government following approval by the Exceptional Medicinal Treatment board. But Malta also has the lowest rate of biosimilar cancer medicine reimburse- ment in the EU, covering only 16% of biosimilar cancer treatments compared to the EU average of 65%. The country faces challenges in pro- curing innovative cancer medicines due to its small market size and limit- ed manufacturing capacity. To address this, Malta has been working with the World Health Organization to develop policies ensuring sustainable and af- fordable access to these medicines. The Malta Community Chest Fund Foundation has also played a crucial role in covering costs, with its expend- iture rising from under €1 million in 2015 to over €20 million in 2022. The report also highlights gaps in can- cer care for irregular migrants, who are often not captured by screening servic- es. The National Health Systems Strat- egy for Malta 2023-2030 includes the establishment of an Immigrant Support Unit to provide holistic healthcare ser- vices for this demographic and improve their access to screenings and clinical programmes. Screening programmes The report also notes that despite the expansion of cancer screening programmes for breast, cervical and colorectal cancers, participation in pub- lic programmes remains low due to the Men in Malta have lower