Mammography Screening and Territorial Inequalities: Why Equity of Access Is Essential in Breast Cancer Prevention
Italy shows significant differences in participation in mammography screening programs due to territorial, socioeconomic, and cultural factors. Mobile mammography units represent a strategic solution to reduce inequalities and reach underserved populations.
PASSI (ISS) data reveal strong territorial disparities: screening coverage reaches 86% in Northern Italy, 80% in Central regions, and 62% in the South, influenced by economic barriers, transportation issues, and fewer specialized facilities.
Migrant women participate less in screening programs, with a gap of up to 50% compared to women born in highincome countries. Mobile mammography units (MMUs) help bridge these gaps by providing accessible, territorybased screening services.
Ensuring equitable access to mammography screening programs is one of the main challenges of breast cancer prevention in Italy. Data from the PASSI surveillance system (Italian National Institute of Health) show a fragmented picture, with significant differences in screening uptake between regions.
In Northern Italy, participation reaches 86%, supported by a denser network of specialized centers, better infrastructure, and more extensive local services. In Central Italy, coverage drops to 80%, while in the South and Islands, it falls further to 62%, partly due to limited services, transport difficulties, and fewer organized screening pathways.
These disparities reflect not only structural differences in healthcare provision, but also socioeconomic, cultural, and logistical factors that affect women’s ability to participate in preventive programs.
Migrant women: an even wider gap
In Italy, migrant women represent about 9% of those invited to screening programs. However, participation rates show a marked disparity:
- 57% for women born in highincome countries (including Italy)
- 45% for women from countries with high migratory pressure
This corresponds to a 28% lower participation rate among migrant women.
The gap exists in Northern Italy as well, but becomes even more pronounced in Central and Southern regions, where participation among women from highmigrationpressure countries is 50% lower than among women born in highincome countries.
Mobile units: bringing prevention where it is needed
These data highlight the importance of bringing screening directly to underserved areas. Mobile Mammography Units (MMUs) are an exceptionally effective tool for overcoming economic, cultural, linguistic, and logistical barriers:
- they reach isolated or underserved areas
- they facilitate participation among women with limited mobility
- they increase coverage among vulnerable populations
- they help reduce territorial inequalities
By bringing mammography services directly into communities, mobile units make it possible to reach women who would otherwise be unable to undergo screening, making them a key ally for equitable and widespread prevention.
Did you know?
Equitable access to screening is essential to reducing breast cancer mortality.
Many associations and regional healthcare networks provide free screening services through mobile units, helping increase participation and reduce territorial disparities.
Sources:
Istituto Superiore di Sanità EpiCentro – L’epidemiologia per la sanità pubblica
Osservatorio Nazionale Screening
GISMa – Linee di indirizzo 2025