Extension of organised cervical cancer screening programmes in Italy and their process indicators.
Since 1996, Italian national guidelines recommend that Regions implement organised screening programmes for cervical cancer. As in previous years since 1998, we have collected from Italian organised cervical screening programmes aggregated tables of data in order to centrally compute process indicators. In 2006, the target population of Italian organised screening programmes included 11,362,580 women, corresponding to 69% of Italian women aged 25-64 years. However, taking into account the proportion of women invited, the actual extension was 52.9%. Compliance to invitation was 38.5%, with a clear North-South decreasing trend. It should, however, be considered that many women are screened outside the organised programmes. The remaining process indicators deal with women invited during 2005 and screened up to April 2006 Of these, 6.1% were recommended to repeat cytology and 57% of them complied; 2.3% of screened women were referred to colposcopy. Compliance to colposcopy was 84.7% among women referred because of ASCUS or more severe cytology and 90% among those referred because of HSIL or more severe cytology. The positive predictive value (PPV) of referral because of ASCUS or more severe cytology for CIN2 or more severe histology was 16.8%. There was a relevant variability of both referral rate and PPV that were inversely related. The unadjusted detection rate of histologically confirmed CIN2 or more severe was 2.7 per 1,000 screened women (2.6 standardised on the Italian population, truncated 25-64).
Ronco
Guglielmo
G
CPO Piemonte, Torino.
Giubilato
Pamela
P
Naldoni
Carlo
C
Zorzi
Manuel
M
Anghinoni
Emanuela
E
Scalisi
Aurora
A
Dalla Palma
Paolo
P
Zanier
Loris
L
Barca
Alessandra
A
Angeloni
Claudio
C
Prandini
Stefania
S
Maglietta
Rocco
R
Mancini
Ettore
E
Pizzuti
Renato
R
Iossa
Anna
A
Segnan
Nereo
N
Zappa
Marco
M
D000328:Adult; D002391:Catchment Area, Health; D005260:Female; D006285:Health Planning; D006305:Health Status Indicators; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D016730:Program Development; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*