Government launches National Cancer Plan

Health Minister Chris Fearne yesterday launched the National Cancer Plan, which sets out an integrated and comprehensive plan of action for the next five years (2017-2021).

Speaking at an event held at the Phoenicia Hotel in Floriana, the Deputy Prime Minister said that the ultimate aim of the National Cancer Plan is to improve a number of identified outcomes that are important for both the patients and society.

These include the:

• Reduction of cancer incidence

• Improvement of cancer survival

• Improvement of patients’ experience and quality of life. • Governance and research

Fearne revealed that the list of state-funded cancer medicines has increased to seven.

Reducing Growth in the number of cancer cases

The report revealed that 1,800 individuals are diagnosed with cancer every year, which is expected to rise to 2,100 by 2020, and 2,500 by 2030.

Between 2010 and 2014 cancer was the cause of death for 29.5% of deaths from illness or disease, with around 900 to 1,000 people succumbing to the illness each year.

The rise in cancer is the result is a combination of factors including lifestyle choices such as smoking (tobacco makes up 20% of all new cancer cases) and environmental exposure to carcinogens.

In men, deficient intake of fruits and vegetables (6.1%), occupational exposures to carcinogens (4.9%) and alcohol consumption (4.6%) have caused cancer.

In women, overweight and obesity (6.9%) relating to breast cancer and infectious agents (3.7%) with respect to cervical cancer have led to cancer.

However, cancer survival is continuously improving with ten year or more survival from all cancers now approaching 50%.

Breast (95.7% for one year, 77.3% for five years, 71.5% for ten years or more), malignant melanoma, testicular, thyroid and prostate (93.9% for one year, 85% for five years, 80% for ten years or more) cancers have seen remarkable improvements.

Survival is low for lung (29.1% for one year, 10.3% for five years, 8.9% for ten years or more), pancreas, stomach, and specific types of acute leukemia, as well as brain tumours.

Several awareness campaigns and reinforcement campaigns on healthy lifestyles will be introduced to target high-risk groups such as youths, while also targeting cancers caused by occupational hazards.

Improving survival through cancer screening and early diagnosis

Early detection of cancer greatly increases the chances for successful treatment.

The National Cancer Plan will continue to regularly update national policies for cancer screening, and use policy to establish and monitor the national cancer screening setup in Malta which will develop and maintain its capability to interact and contribute with other international screening networks.

It will also conduct in-depth assessments to ascertain the reasons for participation in screening programs, and will implement targeted action to reduce socio-economic, cultural, and regional inequalities to access screenings.

Quality surveillance, evaluation and control systems will be consolidated and programs concerning screening performance will be published.

Each screening program will gradually expanded over the next five years, which will follow an evidence-based approach, to create an in-depth evaluation in order to introduce plans to high-risk groups.

This will be coupled with further measures to develop genetic diagnostics and counselling services to assist those with a potential high risk for cancer.

Improving survival and quality of life through integrated cancer care

To support patients’ access to uniformly high quality of care in the community or hospital will be achieved by improving accessibility and availability of high quality diagnostic services while also advocating the strengthening of coordination between specialised, secondary, and primary health care.

The plan will also look to create agreements between the three health care services with the view of increasing the sharing of medical data between health care professionals at all levels of care.

Staff will be required to attend training, while the role of a nurse navigator/ case manager will be established and will be responsible for the coordination of patients’ care management through diagnosis and active treatment phases.

Timeframes have also been placed under particular importance, with aims to establish explicit and reasonable nationally applicable waiting times for diagnosis and the start of treatment.

Pathology systems will be upgraded and updated to a high quality service through synoptic reporting which will conduct regular gap assessments and ongoing horizon scanning for technological and scientific advances to identify the equipment and expertise required which is essential for the confirmation of a cancer diagnoses.

The training of surgeons specifically in the field of interventions in the oncology will be intensified, while mini-invasive operations will be introduced and implemented.

With regards to radiotherapy, the commission of new Linear Accelerators means that the country will be able to deliver advanced techniques, while there will also be analysis for the initiation of brachytherapy treatments in Malta.

It is also advancing measures to better address the challenges posed by rare tumours especially because of the complexity of the diagnostic and therapeutic processes by seeking to further develop systems for the transfer of specialised knowledge and expertise.

The plan’s main guiding principle is to embed rehabilitation and survivorship care plans throughout the continuum of care, from the onset of the disease. Most of these services can be of benefit to a wide range of cancer patients and not only cancer survivors.

It is also advocating for an intensification in the attention that is given to palliative care in comparison to what has been given so far. This amplification requires accessibility to relevant data which is often challenging to attain since information on the structure, process and outcomes of the palliative care phase is often still outside the “main stream” practices for healthcare data collection.

Governance and research

A National Cancer Research Foundation (CRF) will be set up. The CRF will be an organisational structure which is setup through a formal agreement and comprises representation, resourcing and financial allocation from the Department of Health, clinical and academic sectors.

The foundation will map current research activity in terms of objectives and funding to better understand where further public support is needed; will set up a national cancer research register to keep track of all research activity; promote public-private partnerships between policy makers, researchers and the industry.

For further reading access the entire document on http://meae.gov.mt/en/Public_Consultations/MEH-HEALTH/Documents/MinistryForHealth-CancerPlan.pdf