Anna Turrin1, Manuel Zorzi2, Paolo Giorgi Rossi3, Carlo Senore4, Cinzia Campari5, Chiara Fedato1, Carlo Naldoni6, Emanuela Anghinoni7, Giuliano Carrozzi8, Priscilla Sassoli De' Bianchi6, Marco Zappa9. 1. Settore promozione e sviluppo igiene e sanità pubblica, Dorsoduro 3494/A, 30123 Venezia, Regione Veneto, Italy. 2. Registro Tumori del Veneto, Passaggio Gaudenzio 1, 35131 Padova, Regione Veneto, Italy. Electronic address: manuel.zorzi@regione.veneto.it. 3. Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, via Amendola 2, 42122 Reggio Emilia, Italy. 4. AOU Città della Salute e della Scienza, CPO Piemonte, via San Francesco da Paola 31, 10123 Torino, Italy. 5. Staff Programmazione e Controllo, AUSL e IRCCS-Arcispedale Santa Maria Nuova, via Amendola 2, 42122 Reggio Emilia, Italy. 6. Assessorato alle politiche per la salute, viale Aldo Moro 21, 40127 Bologna, Regione Emilia-Romagna, Italy. 7. Servizio Medicina Preventiva nelle Comunità - AUSL Mantova, via Dei Toscani 1, 46100 Mantova, Italy. 8. Dipartimento di Sanità Pubblica, Azienda USL di Modena, Strada Martiniana 21, 41126 Baggiovara, Modena, Italy. 9. SS Valutazione Screening, Istituto per lo Studio e la Prevenzione Oncologica, Via delle Oblate 2, 50141 Firenze, Italy.
Abstract
BACKGROUND: Colorectal cancer screening programmes in Italy invite 50-69-year-old residents for a faecal immunochemical test every two years, regardless of their citizenship. METHODS: The 2013 National Survey on Italian colorectal cancer screening programmes compared immigrants born in low- or middle-income countries with subjects who were born in Italy, by collecting aggregated data on compliance, faecal immunochemical test results, compliance with colonoscopy, detected lesions and stage at diagnosis separately for Italians and immigrants. RESULTS: Overall, 85 screening programmes invited 3,292,451 subjects, of whom 192,629 had been born abroad (5.9%). Compliance with invitation was lower in immigrants (34.3% vs. 51.3% in Italians), with p<0.001. Compliance was higher in females, regardless of the country of birth, in the youngest age group of immigrants but in the oldest of Italians. Immigrants showed a borderline excess of standardised faecal immunochemical test positivity rate at first screening (5.4% vs. 5.1% in Italians, p=0.05) and a significant excess at repeat screenings (4.8% vs. 4.4%, p=0.002). The detection rates for carcinoma and advanced adenomas were lower in immigrants than in Italians at first screening (respectively 1.34‰ vs. 1.62‰ and 8.41‰ vs. 9.25‰) - although the differences were not statistically significant - but not at repeat screening (respectively 1.06‰ vs. 0.98‰ and 6.90‰ vs. 6.79‰). CONCLUSIONS: Migrants showed a lower compliance with screening than Italians. The prevalence of neoplasia was lower at first screening and similar to the Italians' at repeat screenings.
BACKGROUND:Colorectal cancer screening programmes in Italy invite 50-69-year-old residents for a faecal immunochemical test every two years, regardless of their citizenship. METHODS: The 2013 National Survey on Italian colorectal cancer screening programmes compared immigrants born in low- or middle-income countries with subjects who were born in Italy, by collecting aggregated data on compliance, faecal immunochemical test results, compliance with colonoscopy, detected lesions and stage at diagnosis separately for Italians and immigrants. RESULTS: Overall, 85 screening programmes invited 3,292,451 subjects, of whom 192,629 had been born abroad (5.9%). Compliance with invitation was lower in immigrants (34.3% vs. 51.3% in Italians), with p<0.001. Compliance was higher in females, regardless of the country of birth, in the youngest age group of immigrants but in the oldest of Italians. Immigrants showed a borderline excess of standardised faecal immunochemical test positivity rate at first screening (5.4% vs. 5.1% in Italians, p=0.05) and a significant excess at repeat screenings (4.8% vs. 4.4%, p=0.002). The detection rates for carcinoma and advanced adenomas were lower in immigrants than in Italians at first screening (respectively 1.34‰ vs. 1.62‰ and 8.41‰ vs. 9.25‰) - although the differences were not statistically significant - but not at repeat screening (respectively 1.06‰ vs. 0.98‰ and 6.90‰ vs. 6.79‰). CONCLUSIONS: Migrants showed a lower compliance with screening than Italians. The prevalence of neoplasia was lower at first screening and similar to the Italians' at repeat screenings.