Cancer screening participation is growing, but the South is still lagging behind.

In Italy, cancer screening uptake is growing, particularly mammography, which in 2024 surpassed pre-pandemic levels for the first time. However, a significant gap remains between the North and South of the country. This is according to updated data for the two-year period 2023-2024 from the Passi surveillance system of the Italian National Institute of Health.

According to the report, 75% of women between 50 and 69, primarily those who are more educated, affluent, Italian citizens, and married, have had a mammogram within the recommended timeframe, whether within or outside of organized programs. This growth was driven by the increased availability of screenings by local health authorities (ASLs), which allowed for a post-COVID recovery, but significant disparities remain: coverage in the North is 86%, in Central Italy 80%, while in the South it drops to 62%. "Breast cancer prevention," explains Maria Masocco, who coordinates surveillance, "is mostly carried out within the framework of programs organized by the local health authorities, which account for more than half of the women they serve, while the remaining women who have a preventive mammogram within the recommended timeframe do so outside of them." There remains a portion of women who have never had a mammogram: approximately 1 in 10, while nearly 15% have had one for over two years, outside the recommended timeframe.

Regarding colorectal screening, coverage remains lower: 47% of people aged 50 to 69 took a preventive test in the two-year period. Here too, the North leads with 62%, followed by Central Italy (55%) and Southern Italy (30%). Participation occurs primarily through organized programs (39%), while only 8% undergo the test voluntarily. According to the report, the pandemic caused a sharp reduction in colorectal screenings between 2020 and 2021, due both to a decline in availability by local health authorities and lower participation among the population. Coverage began to rise again in 2022, returning to pre-pandemic levels in 2024.

Cervical screening is the one that is struggling to recover the most: in 2024, coverage is 78%, still far from pre-pandemic levels. Here too, the geographic gap is marked: 84% in the North and Center, 69% in the South, with Calabria at the bottom (59%).

Difficulties in regaining adherence are partly due to the pandemic's impact on program offerings and the limited effectiveness of voluntary screening in compensating for the shortcomings of organized programs. Recent changes in protocols, related to HPV vaccination and age-specific screening offerings, may also have had an impact. However, 11% report never having undergone cervical screening. The most common reason given is "I don't think I need it."