Geographic Inequalities in Breast Cancer in Italy: Trend Analysis of Mortality and Risk Factors

Paolo Giorgi Rossi, Olivera Djuric, Simone Navarra, Alessandra Rossi, Anteo Di Napoli, Luisa Frova, Alessio Petrelli

Research output: Contribution to journalArticlepeer-review


We calculated time trends of standardised mortality rates and risk factors for breast cancer (BC) from 1990 to 2016 for all women resident in Italy. The age-standardised mortality rate in Italy decreased from 4.2 in 1990 to 3.2 (×100,000) in 2016. While participation in organised screening programmes and age-standardised fertility rates decreased in Italy, screening invitation coverage and mammography uptake, the prevalence of women who breastfed and mean age at birth increased. Although southern regions had favourable prevalence of protective risk factors in the 1990s, fertility rates decreased in southern regions and increased in northern regions, which in 2016 had a higher rate (1.28 vs. 1.32 child per woman) and a smaller increase in women who breastfed (+4% vs. +30%). In 2000, mammography screening uptake was lower in southern than in northern and central regions (28% vs. 52%). However, the increase in mammography uptake was higher in southern (203%) than in northern and central Italy (80%), reducing the gap. Participation in mammographic screening programmes decreased in southern Italy (-10%) but increased in the North (6.6%). Geographic differences in mortality and risk factor prevalence is diminishing, with the South losing all of its historical advantage in breast cancer mortality.

Original languageEnglish
Article number4165
JournalInt J Environ Res Public Health
Issue number11
Publication statusPublished - Jun 11 2020


  • Aged
  • Breast Neoplasms/mortality
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Italy/epidemiology
  • Mammography
  • Mass Screening
  • Middle Aged
  • Risk Factors
  • Socioeconomic Factors

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