There are still differences in the diffusion of screening campaigns in Italy

Background The oncological diseases are a priority in Italian health care system. We focus on screening campaigns aiming at monitoring the extension and adhesion to the cervical, mammographic and colorectal screening in the Local Health Authorities (LHA)-7 of Siena, but also verifying any critical areas in comparison with the national and regional (Tuscany) standards. Methods For all three screening campaigns we refer to the target population invited in the years 2010-2011, identified through the national registry of patients. The data obtained for LHA-7 were compared with regional and national averages. Results Comparing year 2011 versus 2010, in LHA–7: the cervical screening extension reaches 86.2% (-7.4%), while the adhesion is 45.5% (+2.4%); the mammographic screening extension reaches 95% (+14.8%) while adhesion is 62.1% (-4.1%); the colorectal screening extension is 68% (-17%) while adhesion is 40.2% (-4.4%). In the benchmarking (year 2010) between LHA-7 adhesion and regional/national context, we observe: colorectal screening is a critical area for the LHA – 7, with a lower percentage than both the regional (-6.6%, p < 0.01) than the national (-3.4%, p < 0.01) average. For the cervical screening we record a lower percentage than the regional average (-11.6%, p < 0.01) but higher than the national average (+3.1%, p < 0.01). Finally, in mammographic screening we have a lower percentage than the regional average (-6.4%, p < 0.01), but better than the national average (+11.2%, p < 0.01). Conclusions In Italy is still evident the inadequacy of screening campaigns with a persisting regional variability (a higher spread in the Centre-North than in the South and insular Italy). Between the three active campaigns, mammographic screening shows a slightly better performance (LHA 7, regional and national level), while special attention should be paid to colorectal screening that failed to settle at threshold level identified by literature.