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Country fact sheet: Italy

Population

- Total population: 60 627 498
- Female population: 31 100 617
- Male population: 29 526 881
The World Bank (2016)

Health Expenditure

- Total per capita (US$): 2 700.4
- Out-of-pocket (% of total expenditure on health): 22.8
World Health Organization (2015)

Human Development Index

- HDI: 0.887
- Category: Very high
UNDP Human Development Report (2015)

Geography

Life Expectancy at Birth

- Total population (years): 82.5
- Female population (years): 84.9
- Male population (years): 80.3
The World Bank (2016)

Cancer Burden

- Overall cancer incidence (rate per 100 000 persons per year): 290.6
- Overall cancer mortality (rate per 100 000 persons per year): 94.1
- Most common cancer site by incidence for females (rate per 100 000 persons per year): Breast (92.8)
- Most common cancer site by mortality for females (rate per 100 000 persons per year): Breast (13.8)
- Most common cancer site by incidence for males (rate per 100 000 persons per year): Prostate (61.3)
- Most common cancer site by mortality for males (rate per 100 000 persons per year): Lung (28.7)
- GLOBOCAN 2018 population fact sheet
GLOBOCAN (2018)

BREAST CANCER SCREENING PROGRAMME

Last updated year for qualitative data: 2016
Source of data: Report (EU Report 2017)
Last updated year for quantitative data: 2013
Source of data: Report (EU Report 2017)

Screening protocol

Year published/updated: No answer
Target age (min-max) and screening interval [months] for each test: Mammography
(45-74 years / [24 months] )

Programme status and organization

Dedicated person/team to coordinate the programme: Yes
Budget line for screening programme: Yes
Documented cancer screening policy: Yes
Nature of documentation of the policy: Law
Program introduction was preceded by a pilot: No answer
Year program was initiated: 1990
Screening tests provided free of charge: Yes
Diagnostic tests provided free of charge: Yes
Treatment services provided free of charge: No answer

Information system/Data collection

Data type collected by the programme: Individual and aggregate
The information system collects data outside the program (opportunistic screening/private sector): No answer
Cancer screening registries covering the entire country/region: Yes
Cancer screening data is linked with Population-based cancer registry: Yes

Invitation to screening and further assessment

Method of identification of eligible individuals: From population data
Source of population data: Population register
Annual target for screening coverage: No answer
Invitations to eligible population: Yes, Excluding those covered by opportunistic screening
Method of invitation: letter
Screen positive individuals actively invited for further assessment: Yes
Individuals with a precancer or cancer diagnosis actively contacted: No answer
Program collects data on the treatment of precancer/cancers: No answer

Programme monitoring and quality assurance (QA)

Documented standard operating procedure/policy for QA: Yes
Responsible person/team for QA: Yes
Documented performance indicators and their reference standards to assess the programme: Yes
Evaluation reports are prepared and published: Yes

Cancer Screening programme status

Nature of cancer screening programme: Population-based and non population-based
Current status of implementation (applicable only for population-based programmes): Roll-out completed
Cancer screening programme population based for selected populations: No answer

Performance indicators

Target age and regional limitation if applicable: 50-69 years
Invitation coverage (%): 70.6
Examination coverage (%): 39.1
Participation rate (%): 55.4
Completeness of data related to screening results (%): 100.0
Completeness of data related to further assessment results (%): 96.1
Further assessment rate (%): 5.8
Further assessment participation rate (%): 98.0
Detection rate of CIS and invasive (x 1000): 4.32
Detection rate of invasive cancer (x 1000): 0.69
Positive predictive value of further assessment to detect CIS and invasive (%): 7.6
Proportion of total carcinomas which are CIS (%): 15.9
Benign surgical biopsy rate (x 1000): 0.55
More quantitative data (2013)



CERVICAL CANCER SCREENING PROGRAMME

Last updated year for qualitative data: 2016
Source of data: Report (EU Report 2017)
Last updated year for quantitative data: 2013
Source of data: Report (EU Report 2017)

Screening protocol

Year published/updated: No answer
Target age (min-max) and screening interval [months] for each test: Cytology
(25-64 years / [36 months] )
Triaging test used: Cytology
"screen and treat" included in the protocol: No answer

Programme status and organization

Dedicated person/team to coordinate the programme: Yes
Budget line for screening programme: Yes
Documented cancer screening policy: Yes
Nature of documentation of the policy: Law
Program introduction was preceded by a pilot: No answer
Year program was initiated: 1989
Screening tests provided free of charge: Yes
Diagnostic tests provided free of charge: Yes
Treatment services provided free of charge: No answer

Information system/Data collection

Data type collected by the programme: Individual
The information system collects data outside the program (opportunistic screening/private sector): No answer
Cancer screening registries covering the entire country/region: Yes
Cancer screening data is linked with population-based cancer registry: Yes

Invitation to screening and further assessment

Method of identification of eligible individuals: From population data
Source of population data: Population register
Annual target for screening coverage: No answer
Invitations to eligible population: Yes, For the entire target population
Screening kit included with the invitation: No
Method of invitation: letter
Screen positive individuals actively invited for further assessment: Yes
Individuals with a precancer or cancer diagnosis actively contacted: No answer
Program collects data on the treatment of precancer/cancers: No answer

Programme monitoring and quality assurance (QA)

Documented standard operating procedure/policy for QA: Yes
Responsible person/team for QA: Yes
Documented performance indicators and their reference standards to assess the programme: Yes
Evaluation reports are prepared and published: Yes

Cancer Screening programme status

Nature of cancer screening programme: Population-based
Current status of implementation: Roll-out on going
Cancer screening programme population based for selected populations/regions: No answer

Performance indicators

Target age and regional limitation if applicable: 30-59 years
Invitation coverage (%): 66.0
Examination coverage (invitation cohort) (%): 27.9
Examination coverage (tests in the index-year) (%): 30.7
Participation rate (%): 42.2
Completeness of data related to screening test results (%): 100
Completeness of data related to further assessment results (%): 82.3
Colposcopy referral rate (%): 2.6
Colposcopy participation rate (%): 87.7 (all ages)
Detection rate of CIN2+ (x 1000): 4.14
Detection rate of CIN3+ (x 1000): 2.18
Positive Predictive Value of abnormal screening test to detect CIN2+ (x 1000): 14.9
Positive Predictive Value of CIN3+ (x 1000): 14.9
More quantitative data (2013)



COLORECTAL CANCER SCREENING PROGRAMME

Last updated year for qualitative data: 2013
Source of data: Report (EU Report 2017)
Last updated year for quantitative data: 2013
Source of data: No source

Screening protocol

Year published/updated: No answer
Target age (min-max) and screening interval [months] for each test: FIT: (50-69 years / [24 months] )

Programme status and organization

Dedicated person/team to coordinate the programme: Yes
Budget line for screening programme: Yes
Documented cancer screening policy: Yes
Nature of documentation of the policy: Official recommendation
Program introduction was preceded by a pilot: No answer
Year program was initiated: 1982
Screening tests provided free of charge: Yes
Diagnostic tests provided free of charge: Yes
Treatment services provided free of charge: No answer

Information system/Data collection

Data type collected by the programme: Individual and aggregate
The information system collects data outside the program (opportunistic screening/private sector): No answer
Cancer screening registries covering the entire country/region: Yes
Cancer screening data is linked with population-based cancer registry: PBCR exists but not linked

Invitation to screening and further assessment

Method of identification of eligible individuals: From population data
Source of population data: Population register
Annual target for screening coverage: No answer
Invitations to eligible population: Yes, For the entire target population
Method of invitation: letter
Screen positive individuals actively invited for further assessment: Yes
Individuals with a precancer or cancer diagnosis actively contacted: No answer
Program collects data on the treatment of precancer/cancers: No answer

Programme monitoring and quality assurance (QA)

Documented standard operating procedure/policy for QA: Yes
Responsible person/team for QA: Yes
Documented performance indicators and their reference standards to assess the programme: Yes
Evaluation reports are prepared and published: Yes

Cancer Screening programme status

Nature of cancer screening programme: Population-based and non population-based
Current status of implementation (applicable only for population-based programmes): Roll-out on going
Cancer screening programme population based for selected populations: No answer

Performance indicators

FIT gFOBT sigmoidoscopy Colonoscopy
Target age and regional limitation if applicable: 50-74 50-59
Invitation coverage (%): 57.5 1.4
Examination coverage (%): 26.3 0.3
Participation rate (%): 45.7 24.5
Completeness of data related to screening results (%): 99.4
Completeness of data related to information about attendance to colonoscopy assessment (%): 100.0
Completeness of data related to histology result (%): 100.0
Screen positivity (indication for follow-up colonoscopy) rate (%) : 4.8
Follow-up colonoscopy participation rate (%): 77.6
Completion rate follow-up colonoscopy (%): 92.4
Detection rate of adenomas (x 1000): 14.1
Detection rate of advanced adenomas (x 1000): 7.3
Detection rate of colorectal cancers (x 1000): 1.2
Positive Predictive Value of further assessment to detect adenomas (%): 38.1
Positive Predictive Value of further assessment to detect advanced adenomas (%): 19.7
Positive Predictive Value of further assessment to detect colorectal cancers (%): 3.5
More quantitative data for FIT (Male - 2013)
More quantitative data for FIT (Women - 2013)
More quantitative data for Flexible sigmoidoscopy (Male - 2013)
More quantitative data for Flexible sigmoidoscopy (Women - 2013)