Cancer remains a major cause of morbidity and mortality in the Maltese Islands. Preventing, diagnosing and treating it is become a more and more sophisticated matter. To do this properly the country needs an integrated, strategic plan for the next 5 years. The Ministry for Health has just published such a plan. This Plan is presenting the strategies that Malta will be adopting to continue improving the provision of public cancer control services over the five-year period until 2021.
This National Cancer Strategy is all about people. It is about preventing cancer across our population, diagnosing cancer early, providing optimal care and maximising the quality of life of cancer patients and survivors.
Significant progress in cancer control was made in Malta over the past decade and especially through the implementation of the first national cancer plan. We now aim to take on the challenge of making further strides in cancer control such that survival rates can consistently approach the top quartile of European countries and the desired changes in the care provided to improve the quality of life of patients and survivors is attained.
Presently, in Malta, approximately 2000 persons are being diagnosed with cancer each year while almost 900 deaths (about 30% of all deaths) are attributed to cancer annually. Additionally, the number of people in Malta diagnosed with cancer since 1994 and surviving this disease is estimated to have surpassed 12,000 individuals amounting to about 3% of the total population. National five-year survival rates have shown notable improvements especially for cancer sites such as breast, prostate, large bowel and childhood cancers and we can expect further improvements for the cancers that are now covered by a national screening program (breast, large bowel and uterine cervix).
Cancer prevention is a cornerstone of this Plan as it offers the most cost-effective, long-term approach for cancer control to decrease the burden of this disease on individuals and on the population in general. Smoking is by far the most important factor but other important elements that increase risk include excess body weight, poor diet, physical inactivity, alcohol consumption, specific infections, radiation and occupational hazards. This Plan will be promoting the European Code Against Cancer (accessible from http://cancer-code-europe.iarc.fr/index.php/en/) to increase cancer awareness and will be tackling the effect of health inequalities in the access to cancer control services as this is generally associated with poor symptom awareness, delayed presentation and low uptake of services, including screening.
Particular focus will be put on achieving integration across primary, acute and social care services. In this regard, the key element in this Plan is to plan for and implement measures that aim to ensure the continuum of care across the whole care journey of a cancer patient from early diagnosis, to the provision of evidence-based, high quality patient-centred treatment, appropriate follow-up and support.
With the significant and incessant increases in cancer survivorship, optimising peoples’ quality of life is becoming increasingly more important especially from the patients’ and survivors’ perspectives. The emphasis on quality of life is central theme of this Plan as it focusses on increasing the national capacity for rehabilitation and survivorship, psycho-social and palliative care services.
Another important theme is the promotion of cancer research. The positive impact of research activity, including clinical trials, on the care of patients is now universally accepted. The development of a culture in the cancer care system that values research to the benefit of patients, and is supportive of those who engage in it, is an aim of this Plan. One of the measures that were included to help achieve this objective is the setting op of a national Cancer Research Foundation.
This Plan embraces concepts of cancer control that emerged internationally over the past few years. It is presenting us with several new opportunities and ongoing challenges in cancer control that we need to unwaveringly continue to address and manage. The Plan aims to provide leadership and direction to ensure that service priorities are aligned with desired and monitored outcomes and that the needs of patients and survivors are better identified and met.