Cervical cancer screening in the Ferrara Local Health Authority catchment area

Since 1996, the Emilia-Romagna Region has been promoting screening programmes for cervical cancer, selecting resident women aged 25-64 as a target population. This analysis concerns a second round of screening performed in the city of Ferrara and its province. A total of 103,971 women were invited to be screened, but only 55.51% of them arrived on the day of the scheduled screening. We therefore decided to investigate the reasons for this lack of participation using preliminary findings from the local screening program registry. These indicated that non-attendance was related to variables such as area of residence and age, and significant differences were observed between localities, with a consistently greater participation in industrial neighbourhoods and their surroundings than in rural areas. In order to elucidate these observations further, a cross-sectional survey, placing special emphasis on setting, area of residence, age and level of education, was performed by structured telephone questionnaire, in order to identify the reasons behind non-attendance. Approximately 94% of the contacted women agreed to be interviewed, thereby demonstrating that a telephone interview is a valid means of collecting data in such cases. It should be noted that, among the women unwilling to respond to the questionnaire, a marked increase in percentage was observed for those resident in rural areas, of whom approximately 50% fell into the under-40 age group. The results of the survey indicated, as demonstrated by several previous studies, that age and the area of residence are both determining factors in the decision or not to participate in a screening programme. It was also observed that women who had completed the lower and upper secondary school education were shown to pay greater attention to health matters than those who had not.