Cancer prevention: Breast screening in Italy

Francesca Lariccia, Università di Roma "La Sapienza"

General objective of this paper is to investigate geographical and socio-demographic differences in the participation at the Breast Screening (BS) programmes in Italy, and give some indications to the local institutions. Breast cancer is one of the most important causes of death among adult women in Europe. Early detection and treatment can prevent the development of breast cancer in 75% of cases and reduce 30% of breast cancer mortality. The WHO recommends all women between the ages of 50 and 69 to have BS every two years. (WHO, 2005) Recently, in Italy the admininistrative regions have planned BS programmes according to the national and international guidelines and recommendations (European Commission, 2006; Piano Nazionale della prevenzione, 2005-2007). These programmes are still non uniformly implemented in the whole country in terms of North-South differences, cover, participation, and quality. Aim of this paper is to investigate the adherence of BS programmes respect to recommendations, in terms of timing, frequency, and absence of BS. I expect that the determinants of this adherence are dissimilar in the different administrative regions. Particularly, I expect that in the regions of the South, where programmes are recent or underdeveloped, high socio-economical status and young age favour to have breast screening in accordance with guidelines/recommendations; on the contrary, in the regions of the North, where programme are stable and well-established, I expect that the same women’s characteristics favour an excess of BS (too early, too often). To answer at these questions, methods of event history analysis (Life Table Method and Piecewise Exponential Model) are used: the dependent variable is the first BS and covariates are socio-demographic, geographical and temporal variables. Data are from PASSI 2005, a retrospective survey directed by the Italian National Institute of Health. This survey collects representative data on health behaviors at local level.