Cancer: Screening participation is growing, but testing is slow to take off in the South.

Uptake of preventive cancer screening is growing in Italy, with mammography rates exceeding pre-pandemic levels. However, a significant geographic disparity remains, with the South recording the lowest participation. This is confirmed by data from the 2023-2024 Passi surveillance program from the Italian National Institute of Health, which shows that "75% of women between the ages of 50 and 69 underwent preventive mammography screening." However, the proportion of women aged 50 to 69 who have never had a preventive mammogram or have had it performed poorly is not negligible: 1 in 10 women has never had a mammogram, and nearly 15% report having had one more than two years ago.

"Screening," emphasizes Maria Masocco , who coordinates the surveillance, "is mostly done through programs organized by the local health authorities (ASLs). More than half of the women targeted participate in these programs, significantly reducing social inequalities in access to prevention. For the majority of women with less education or greater economic hardship, public screening represents the only option for breast cancer prevention."

The percentage of women undergoing mammography screening is higher among those with higher education or greater economic resources, among Italian women compared to foreigners, and among married or cohabiting women. Coverage is uneven between North and South, with total coverage of 86% in the North, 80% in Central Italy, and only 62% in the Southern regions. Friuli Venezia Giulia (90%) is the region with the highest coverage, while Calabria (46%) has the lowest total coverage. Over the years, however, the geographic gap has narrowed, and the percentage of women undergoing preventive mammography has increased, thanks primarily to increased availability and enrollment in organized programs across the country.

National colorectal screening coverage, however, remains quite low: in the two-year period 2023-2024, 47% of respondents in the 50-69 age group reported having undergone a preventive screening test. "There is significant variability from North to South," the ISS emphasizes, "again, to the detriment of the southern regions, where the percentage of people undergoing screening reaches just 30% in the two-year period 2023-2024, a figure that reaches 55% in central regions and 62% among residents of Northern Italy."

The majority of people who underwent colorectal screening did so as part of programmes organised by the local health authorities (39%), whilst spontaneous screening (i.e. outside of the local health authorities' offerings) was rare (almost 8%).