[Insurance against occupational cancer in Italy and in Europe]

European and Italian data show a marked under ascertainment of occupational cancers: only a small proportion is recognized, although for the majority of them the etiological fraction attributable to the workplace is high. Since more than 20 years Patronato INCA is active in order to reduce this gap. Its commitment to spread scientific knowledge has paralleled the action intended to make social security rules more favourable to workers, as well as to improve hygiene and safety in the workplace. Particular attention has been given to updating both the Italian list of occupational diseases for which notification is compulsory (which includes all Group I carcinogens according to IARC) and the Italian tables of occupational diseases. The latter are of particular relevance to the Patronato because, within the Italian norms, causality is approached in different terms according to whether a disease is or is not included in the tables. Together with changing the tables, a theoretical elaboration regarding causality, as required by multifactorial diseases such as occupational cancer, has been carried out. Such a constant commitment to bring to the surface occupational diseases is based on the belief that the right to compensation of workers who turned ill because of the work is important, and even more on the belief that identification of occupational diseases is most important for primary prevention.