Breast cancer: two million more women will have free access to screening

Prevention and early diagnosis of breast cancer will become accessible to about two million more women thanks to the expansion of the age range of free mammography screening. The manoeuvre, which is awaiting the Senate's scrutiny, provides for the screening to be offered to a new group of recipients aged 45 to 49 and 70 to 74, as required by the relevant European guidelines. Currently, in Italy the mammography screening programme is aimed at women aged between 50 and 69, although some virtuous Regions have already extended this opportunity to a wider segment of the female population. The prevention programme can thus become fairer and more effective in detecting breast cancer, which ranks first among female cancers in terms of incidence and mortality.

The initiative was applauded by associations concerned with women's health. Such as Europa Donna Italia, which was set up in Milan in 1994 by an idea of Umberto Veronesi and on the initiative of the European School of Oncology, and fights for the rights and needs of women with breast cancer, presenting itself as the main opinion movement on the subject. Europa Donna Italia, which coordinates a network of 185 associations throughout Italy, took part in a meeting with parliamentary institutions in Rome on 28 October, during which it presented the Policy Brief 'Benefits and Impact of Widening the Age of Mammography Screening'. "We have produced this second Policy Brief - declares Rosanna D'Antona, president of Europa Donna Italia - with the aim of proposing national and regional interventions and communication strategies capable of improving adherence to organised mammography screening programmes. The first request we formulate in the document is precisely the extension of the age range, from 45 to 74, in all regions. In order to involve civil society on this issue, we have launched the social campaign 'Luck costs, bad luck more', which to date has collected more than 2,500 adhesions to demand that the two million women, today excluded by age from the mammography screening programme, can finally access it".

Detecting the disease at an early stage is crucial. "If the tumour is intercepted at an early stage," pointed out Paola Mantellini, director of the National Screening Observatory, "everything changes: it can be cured with less invasive and more effective therapies, more conservative surgery, and survival at five years from diagnosis in Italy now exceeds 90%. This is why screening represents a life-saving measure and the extension of its age range is crucial'. The report 'Extension of the Mammography Screening Programme in Italy: Cost-Benefit Analysis and Impact of Early Diagnosis in the 45-74 Age Group', presented by Altems Advisory, a spin-off of the Università Cattolica del Sacro Cuore in Rome, and commissioned by Europa Donna Italia to analyse the cost-benefit ratio of extending the age group throughout Italy, contains an estimate of the number of cases of breast cancer that could be diagnosed early, amounting to approximately 17.527, with an equal distribution between those at an early stage and those at a locally advanced/metastatic stage. This means that a significant number of women could benefit from less invasive and more effective treatment with less need for complex care and a better overall prognosis of the disease.

The economic investment needed to extend screening nationwide,' the report states, 'has been estimated at about EUR 64.6 million, considering only the costs of mammography and related diagnostic examinations. The overall savings resulting from early diagnosis and the reduction of advanced cases has been calculated at about €35 million for the National Health Service, plus a saving of over €71 million for the regions that currently finance the programme with their own resources, the Altems Advisory report specifies.

In our country, there are currently six regions that have adopted the full extension of the age range of mammography screening from 45 to 74 years. In all the others, the extension is only partial or completely absent and screening therefore remains limited to women between 50 and 69. "These are disparities that are not good for women's health," said Corrado Tinterri, coordinator of the Technical Scientific Committee of Europa Donna Italia. "Today, 40% of patients diagnosed with breast cancer are under 50: many of them remain excluded from screening programmes. Yet, as early as 2017, the European Guidelines recommend extending the age range from 45 to 74. It is time to give a uniform response to these indications'. Another key issue to be addressed is that of screening adherence, which currently stands at around 43%, and one of the main goals of any expansion would be to increase this percentage through awareness-raising campaigns and facilitating access to diagnostic services.