On the one hand there is the complexity of a pyramid of the population that sees inexorably grow the share of the elderly, At the expense of young people and children. On the other there are chronic pathologies that affect a wide range of the population.
Let’s look at the numbers: almost One in four people are over 65 years old. And in this age group at least half of people present (at least) two different chronicities. In a situation of this type, focus on prevention It appears to be fundamental. But on this front we are not put well, according to what was launched in a meeting organized by Foce (Federation of Oncologists, Cardiologists and Hematologists). The figures say it: Italy dedicated only 4.8% in 2022 and 4.5% in 2023 of its total health expenditure for prevention.
Because there is a need for prevention
The numbers say Italy can and must improve. The fee dedicated to prevention places us behind almost all western European countries, abundantly under the average of the OECD and last among the G7 countries. We spend only 193.26 euros per inhabitant Compared to the European average which is 213.18 euros (tenth place in the ranking of European countries). There public health expenditure For prevention it also fell by 18.6% between 2022 and 2023 from 10 billion to 8 billion and 453 million. According to experts, this situation may have Very negative consequences In an increasingly older country like Italy. In fact, over 24% of the population is over 65 years old and half of them have at least two chronic diseases. Priority is therefore investing in prevention in particular by enhancing the vaccinationsfor citizens of every age group, and cancer screening. The adhesion rates to the secondary prevention programs of tumors are still insufficient and very far from the objectives required by international institutions. The same goes for immunizations to serious pathologies that can affect above all children and the elderly.
More screening for early diagnosis
In 2023 the adhesion to organized oncological screening programs It was irregular at a territorial level with very low values in Lazio and in the South regions.
Reports Francesco Cognetti, president of Foce:
“In 2023 only an over 50 out of three carried out the search for the hidden blood of the feces. 53% and 46% of women instead did respectively mammography and the HPV or Pap Test, in the same year. Europe had asked, in its Beating Cancer Plan, to all member countries of reach 90% membership by 2025this is a result for us absolutely unattainable. Recall that they are completely free exams for their respective target populations and that they favor the early diagnosis of colon-recto carcinomas, of uterine cervix and of the breast. They are three very popular tumors and which only last year hit more than 104 thousand men and women residing in our country. Tests like mammography, if performed regularly, can actually reduce the mortality from breast cancer. It is evident that it must be incentivized and also extended by offering it free of charge to women between 45-50 years and those between 70-74. It was even recently even rejected in parliament An amendment that allocated an insufficient sum of 6 million in 3 years for the extension of breast screening to these age groups. Therefore, more economic resources are needed to guarantee this right to all towns. Other important new screenings have not yet been introduced such as, for example, the spiral CT for the early diagnosis of lung cancer in the strong smokers and gastroscopy for stomach tumors “.
Prevention in children and adults
Cancer prevention must start with very young with the vaccination against the papilloma virus or HPV. Cognetti reiterates that there is space for improvement. Thanks to vaccination, it can be aimed to totally eradicate over 7,500 cases of cancer per year in Italy. Immunizations are also free for all teenagers. The latest female national data indicate for 2011 cohort to 45% while 60% for the 2010 cohort.
“We are therefore very far from the 95% threshold suggested by WHO to definitively defeat all related HPV tumors in Italy, including the carcinomas of the neck of the uterus. Among others Pediatric age vaccines The hexavalent protects children from diphtheria, tetanus, pertussis, polio, hepatitis B and the infections from haemophilus influenzae type B – continues Alberto Villani, director of the pediatrics of the Bambino Gesù hospital in Rome. The recommended coverage is 95% while in 2022 we only came to cover 91%. In fact, we register worrying increases in diseases such as measles which can cause very serious side effects to individuals of all ages. Vaccinating children is also essential to protect adults “
Cognetti comments. “
The way to go
As Massimo Andreoni points out, scientific director of the SIMI-Italian Society of Infectious and Tropical Diseases:
“Even on the adult vaccinations front the data are not very encouraging. Against the seasonal influence we are just above 50% while against the pneumococcus We do not reach 30% of immunized adults. The share even drops to 5% for the‘Shinglesa virus that causes a painful rash and that can also have serious consequences for fragile people. It has been calculated that only thanks to these three vaccines could there be costs up to 10 billion euros. However, the coverage objectives of 75% for influence and pneumococcus and 50% for Herpes Zoster should be achieved for over 65 and oncological patients. “
Adds Giovanni Rezza, extraordinary professor of hygiene at the Vita-Salute San Raffaele University of Milan:
“Covid-19 is still not to be underestimated for the 2023-24 season only 16% of over 80 (16th place among all European countries) has vaccinated while in other European countries the average is between 60 and 90%. Five years after the beginning of the pandemic Many have lowered their guard towards a virus that is now considered definitively defeated. The most difficult period has now passed, however, Covid can still represent a problem for millions of people. In fact, in our country a few thousand citizens have still deceased to Covid over the past few years. In the fragiles and large elderly, the vaccine is still useful to reduce the risk of serious forms of Covid “.
