The data in this report confirmthe progressive expansion of screening programmes. First and foremost, this shows the continuing positive efforts of the regional health systems. More than from the financial aspect, this effort is also characterised by great cultural and organizational commitment; the screening programmes implemented in our country represent an exemplary intervention of secondary prevention in public health.

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On the other hand, however, the incomplete distribution of such interventions, considered by our legal system as Essential Levels of Care, becomes a litmus test for the crucial problems affecting regional systems, especially, but not only, in the South of Italy. In this context, activities of the central government have increased commitment with its planning.

Although at present neither the National Plan of Prevention, nor the National Cancer Plan have concluded the institutional process that will make them formalized planning instruments; both of these reaffirmtheir commitment to promoting the extension and improvement of cancer screening programmes. In fact, this is considered among the specific objectives of these two plans.

Regarding the first, screening programmes became models of intervention for secondary prevention mainly due to the involvement, based on solid scientific evidence, of all health system structures (hospital and area).

With regard to the Cancer Plan, aimed at putting Italy on the forefront in facing the burden of cancer, the mass-screening programmes actually involve the greatest number of people in activities against cancer.

Data collected in this report also show the need to guarantee the quality of the intervention more evenly. This effort must concentrate the resources and commitment of all the stakeholders: institutions, professionals, scientific societies, associations representing civil society, and the media. On the other hand, the evidence of things that need to be improved must not lead us to forget how seldom the quality of health interventions can be evaluated in other settings. It is therefore with great pleasure, as well as critical awareness, that I introduce this report with the hope of seeing the gap quickly filled that sometimes separates us fromfully achieving our objectives of distribution and quality, so that the work and commitment of so many workers can fully and effectively show the entire target population the benefits made possible by the health screening programmes.

Fabrizio Oleari
General Prevention Director CCM Managing Director


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F. Oleari
p. 5
The diffusion of screening programmes in Italy: 2008
M. Zappa, G. Grazzini, C. Naldoni, E. Paci, Nereo Segnan, A. Federici
p. 9
Mammography screening in Italy: 2008 survey
D. Giorgi, L. Giordano, L. Ventura, A. Frigerio, E. Paci, M. Zappa
p. 27
Time trends of process and impact indicators in Italian breast screening programmes: 1998-2008
L. Giordano, D. Giorgi, L. Ventura, V. Stefanini, C. Senore, R. Castagno, E. Paci, N. Segnan
p. 35
Extension of organised cervical cancer screening programmes in italy and their process indicators, 2008 activity
G. Ronco, P. Giubilato, C. Naldoni, M. Zorzi, E. Anghinoni, A. Scalisi, P. Dalla Palma, L. Zanier, A. Barca, C. Angeloni, M.D. Giaimo, R. Maglietta, E. Mancini, R. Pizzuti, A. Iossa, N. Segnan, M. Zappa
p. 53
Screening for colorectal cancer in Italy: 2008 survey
M. Zorzi, S. Baracco, C. Fedato, G. Grazzini, C. Naldoni, P. Sassoli de' Bianchi, C. Senore, C.B. Visioli, C. Cogo
p. 73
Quality of colposcopy and treatment: data from the national survey of Italian organised cervical screening programmes. 2008 activity
R. Volante, P. Giubilato, G. Ronco
p. 81
Audit system on Quality of breast cancer diagnosis and Treatment (QT): results of quality indicators on screen-detected lesions in Italy, 2007
M.P. Mano, A. Ponti, M. Tomatis, D. Baiocchi, A. Barca, R. Berti, R. Bordon, D. Casella, D. Delrio, G. Donati, F. Falcini, A. Frigerio, A. Furini, P. Mantellini, C. Naldoni, G. Pagano, P. Piccini, A. Ravaioli, D. Rodella, A. Sapino, M.L. Sedda, M. Taffurelli, M. Vettorazzi, M. Zorzi, L. Cataliotti, N. Segnan