Well all good intentions for the new year, but between enrollments in language courses and gyms, there would be one important goal to put before all the others, that of safeguarding one’s health and following the (free) prevention and screening paths that can save us life, as well as extending it by avoiding treatments, complications and invasive therapies. Frances Mezzettidirector of the screening unit of the Ausl of Bologna, gives an overview of the opportunities that the prevention plan provides for all citizens, clearly subdivided by risk range: “Thanks to screening, the reduction of mortality and cancer has of 30% and the number is important if we consider that adherence is very low (it is hard to reach 60%).As regards breast cancer, mortality has decreased by 56% and this makes us understand that We say it enough: take the test!”
So, which screenings are available today and who are they aimed at?
“Let’s start with the screening for the cervical cancer. All women aged between 25 and 64 residing and domiciled in the Bologna Ausl area are invited to participate in this screening by receiving a letter at home and via the Electronic Health Record with all the information relating to access methods, locations and the timetables. Between 25 and 29 years the offer of the paptest takes place every 3 years and between 30 and 64 years of the HPV test. The latter has a double option since it can also be done at home. As for the breast, all women between the ages of 45 and 74 are invited to do it by home letter which already gives all the info. From 45 to 50 years old it is annual while for ladies aged between 50 and 74 the invitation arrives every two years. Screening for the colorectal cancer it affects men and women aged 50 to 69. This segment of the population is invited to perform a free test for the detection of occult blood in the faeces, every two years. This year alone we had Hepatitis C screening for those born between ’69 and ’89. Those who received the notification last year and have not performed the test still have time to join: important because with the new anti-viral drugs it is possible to make treatments that prevent the disease from becoming chronic or from becoming a tumor simply with a trivial therapy by mouth”.
Frances Mezzetti
All about breast cancer screening
In the past, the number of new cases of breast cancer has progressively increased; however, mortality appears to be declining, suggesting the benefit of the screening program which allows for early diagnosis and more effective treatments. The etiology of the vast majority of cases remains unknown. However, numerous risk factors have been highlighted including: older age, family history of breast cancer at a young age, early menarche and late menopause, older age at first birth, prolonged hormonal therapy substituted, chest wall exposure to previous radiation therapy, benign proliferative breast disease, and genetic mutations, such as the BRCA 1-2 genes.
Methods of involving the population. Since 1 January 2010, the year in which the range of the target population was expanded, all women between the ages of 45 and 74 are invited to be screened with a home letter indicating the place, day and time to present themselves to perform the screening. mammography. An information brochure is attached to the invitation letter, which explains the reasons and methods for carrying out the screening mammography. The invitation is made periodically: for ladies aged between 45 and 49 the invitation arrives every year, for ladies aged between 50-74 the invitation arrives every 2 years. Invitations and reminders can only be sent via Electronic Health Record (FSE) if consent to the delivery of reports within the FSE has been expressed. Participation in the program is completely free and a referral from a general practitioner is not required. If further tests are needed, these are performed free of charge as part of the program and, as with the basic mammography, no referral from the attending physician is required. This allows the health of the woman who joins the program to be monitored.
Where to take the exam in Bologna
Mammograms are performed: in the 3 outpatient clinics of the Local Health Authority of Bologna: Casalecchio, San Lazzaro di Savena, San Pietro in Casale in the 5 hospital locations of the Local Health Authority of Bologna: Bazzano, Bellaria, Bentivoglio, San Giovanni in Persiceto, Vergato and at the University Hospital of Bologna.
Cancer prevention, screening on the rise: “We gain membership with innovative projects”
Learn more about colorectal cancer screening
The screening program for the prevention and early diagnosis of colorectal cancer is active in the Bologna Local Health Authority, with the collaboration of the Sant’Orsola-Malpighi University Hospital. All the male and female population aged between 50 and 69 residing or domiciled in the area of the Local Health Authority of Bologna are invited to carry out a free test for the search for occult blood in the faeces, every two years.
The whole screening program is free and there is no binding request from the general practitioner. Citizens with the characteristics highlighted above receive a letter of invitation to their home, accompanied by specific information material or an invitation in their Electronic Health Record for the execution of the screening test every two years.
The sample must only be delivered to the pharmacy: by presenting the letter of invitation, the health card and an identity document, it is possible to receive the kit for carrying out the test at the pharmacies in the company area that have joined the screening programme. . Once the stool sample has been collected, citizens will have to take it as soon as possible (and in any case no later than 48 hours from collection) to the participating pharmacies.
Delivery of the report/test result: if the test gives a negative result (i.e. in the absence of occult blood in the faeces), the report will arrive by post at home or will be published in the Electronic Health Record. If the delivered sample is not adequate, i.e. not analyzable, the person will receive a new invitation letter to repeat the exam. In the event of a positive outcome (presence of blood in the stool), the person will be called back by telephone by the health personnel of the Screening Center to propose an appointment for an interview with the nursing personnel of the Gastroenterology operating units located in the Bellaria, Bentivoglio, San Giovanni in Persiceto hospitals and S.Orsola-Malpighi. In these offices all the necessary information will be provided and the diagnostic study path will be planned and, if necessary, an appointment for the colonoscopy will be fixed.
Cancer screening and prevention: for the Bolognese there is an ad hoc “booklet”.
Find out more about cervical cancer screening
Cervical cancer represents an important health problem, as it is the second malignant tumor in women worldwide. In the countries that have started organized screening programs based on the Pap-test offer, in the last decades there has been a significant decrease in the number of new cases of this neoplasm and at the same time the probability of recovery has greatly increased. Cervical cancer is totally attributable to persistent human papilloma virus (HPV) infection. Among the genotypes of this virus that infect the neck of the uterus, only a few, called high-risk HPV, are capable of causing lesions that can progress towards cancer over time. Other genotypes are associated with benign lesions such as anogenital warts.
There is a vaccine against the types of viruses responsible for about 70% of cervical cancers. Starting from the first months of 2016, the HPV test will be introduced as the main test to replace the Pap test for the age group from 30 to 64 years. Indeed, some studies have shown that in this age group, the HPV test is more effective in early identification of lesions at risk for cervical cancer. The HPV test is a very similar test to the Pap test; the material taken is examined for the presence of HPV viruses. In the age group between 25 and 29, however, the Pap test remains the most effective test.
All women between the ages of 25 and 64 residing and domiciled in the Bologna AUSL area are invited to participate in the screening by letter at home and via the Electronic Health Record, indicating the access methods, locations and times. The Pap test and the HPV test are performed by a midwife in the Family Consulting offices. The invitation is every three years for the Pap-test and every five years for the HPV test. Participation in the screening is completely free and you do not need a referral from your doctor.
Possibility of self-taking HPV test. Since November 2021, a new method of carrying out the test independently with the collaboration of participating pharmacies has been offered to women between 30 and 64 years of age by specific invitation. If the screening test is negative, a letter will be sent home with the result. If the test reveals any alterations, the lady will be summoned to carry out further investigations. These insights are free and you don’t need a referral from your doctor. This makes it possible to constantly monitor the health of the woman who adheres to the Screening program thanks to the involvement of a team of professionals from various Services (Screening Centre, Family Consultations, Pathological Anatomy, Gynecology).
Cervical cancer, the screening program will change from 2023
Hepatitis C: how screening to detect HCV works
Anyone born between 1969 and 1989 can do it, or if you are followed by the Public Services for Addiction (SerD), you can book the test which consists of a blood sample for free. No medical prescription is required and no co-payment is required. The test can be performed together with other blood tests and it is possible to adhere to the hepatitis C screening also during other blood tests, by requesting it directly at the blood sampling center counter.
Hepatitis C is a dangerous infection: many infected people develop chronic liver disease, which can evolve into very serious and progressive forms ranging from cirrhosis to liver cancer. Screening is the only way to detect it: Most people with chronic hepatitis C have no symptoms or only general symptoms such as chronic fatigue and depression. Thanks to screening, it is possible to identify unknown cases and provide the right therapies, allowing to prevent the evolution of the disease and prevent the contagion of other people.