PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

Case Study

Volume 5 Issue 1

Proactive Medicine and Proximity Health Services, Fundamental Primary Tools for Breast Cancer Screening: The Role of the “micro-team” in Primary Care

Arianna Moretti*, Simona Cardano and M Zamparella

June 27, 2024


Background: The recent results published in the annual report HOLOGIC GLOBAL WOMEN’S HEALTH INDEX have shown that Italian women are among the least involved in cancer prevention programs: in fact, only 11% have undergone an organised screening pathway in the last 12 months, while the average in Europe is 20%.

Aim: Through an active call, a path of proactive medicine has been realized by attracting all women between 40 and 74 whose computerized medical records did not show the execution of a mammography in the last two years.

Material and Methods: Starting from MilleWin medical records management software, MilleGPG search engine has been used to extract from the total number of patients (1630) all women between 40 and 74 years who had not performed a mammography in the last two years. The women were contacted by telephone by the clinic nurse, who ascertained that the mammogram had not been performed during the previous two years and, in compliance with the regional guidelines of breast cancer screening, short motivational counselling was carried out to highlight the importance of prevention and achieve individual empowerment in order to increase adherence to screening. In detail, for the achievement of the goal, a dematerialized prescription was sent to women aged between 40 and 44, those aged 44 to 49 were sent a dematerialised prescription with an exemption code, while women aged 50 to 74 were redirected to organised regional screening. Women with a previous diagnosis of breast cancer were excluded from the active call.

Results: In a group of 874 women, out of a total of 1630: 53 were in the 40-44 age group, 72 in the 45-49 age group, 313 in the 50-74 age group, and 36 (4%) had had a breast cancer. The extrapolation of the data from the medical records showed that there were no results of mammography performed in the previous two years in: 24 out of 53 in the 40-44 age range, 37 out of 72 in the 45- 49 age range and in 156 out of 313 in the 50-74 age range.

All these patients were contacted by phone with a confirmation of not having performed a mammography in 11 out of 24 women in the 40-44 age group; in the 45-49 age group 4 out of 37 women had performed one more than 2 years ago and 10 had never performed one; in the 50-74 age group 60 out of 156 women had performed a breast screening more than 2 years ago while 5 had never performed one. 37 patients never answered the active call. The total analysis showed that 217 women were not reported in the folder, 37 of these did not respond, 90 had performed the test without declaring it and 90 other were redirected to screening.

Conclusions: Our study project confirmed that Italian women adhere less to cancer screening than women in other European states, the reasons are multiple but the prevailing cause is the workload and the same dedication to the family that characterizes the Italian woman as the caregiver of the whole family. Despite the many reasons, the numerous organizational obstacles and the different strategies between the Regions, the structuring of a proactive medical path allows to increase the adhesion to cancer screening by realizing without additional costs a support and a strengthening in Primary Care to the network of organized screening. This project shows that proximity medicine also serves to produce health and not only to provide social and health care, and that the “microteam” of the Primary Care Physician can be a valid territorial unit in cancer screening.

Keyword: cancer screening; proactive medicine; proximity health services; motivational; counselling


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