Azzolini Elena, Cereda Danilo, Piccinelli Sara, Viscardi Michela, Deandrea Silvia
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Milan, Italy.
IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Milan, Italy.
Healthcare (Basel). 2025 Aug 18;13(16):2041. doi: 10.3390/healthcare13162041.
: Prostate cancer is the most frequently diagnosed cancer among men in Italy, yet no national population-based screening program exists. In response to new European Council recommendations, the Lombardy Region launched a pilot in November 2024 to assess the feasibility of a digitally enabled, risk-adapted screening model. : Men turning 50 were invited to voluntarily self-enroll through the regional electronic health record (FSE). A digital questionnaire assessed eligibility and family history (FH); eligible individuals (97,849 men without a PSA test in the past two years in the regional database) were offered free PSA testing. Risk stratification guided follow-up: men with PSA >3 ng/mL or a positive FH were referred to urology; others were assigned 2- or 5-year recall based on PSA level. : By June 2025, 8558 men had enrolled (8.7% uptake), 6072 were eligible; 644 (10.6%) reported a positive FH. Among those tested, 58.4% had PSA < 1 ng/mL and were FH-negative, 25.8% had PSA > 1 and <3 ng/mL and were FH-negative, and 15.9% met referral criteria. Digital triage was efficient and ensured care continuity without burdening specialists. Participation varied by local health authority (ATS), depending on implementation context. Preliminary data show a 25.9% reduction in urology consultations and a 35% reduction in MRI use compared to standard care, with no biopsy rate increase. : The pilot demonstrates the technical feasibility, safety, low administrative burden, and potential sustainability of digital, risk-stratified prostate cancer screening. While participation was low without active invitations, early results support expansion with improved outreach. Lombardy's experience offers a scalable, EU-aligned model for broader implementation across Italy and other health systems seeking to balance early detection with resource efficiency.
前列腺癌是意大利男性中最常被诊断出的癌症，但该国尚无基于全国人口的筛查计划。为响应欧洲理事会的新建议，伦巴第大区于2024年11月启动了一项试点项目，以评估数字化、风险适配筛查模式的可行性。50岁男性被邀请通过地区电子健康记录（FSE）自愿自行登记。一份数字问卷评估了资格和家族史（FH）；符合条件的个体（地区数据库中过去两年未进行前列腺特异性抗原（PSA）检测的97849名男性）可获得免费PSA检测。风险分层指导后续跟进：PSA>3 ng/mL或家族史呈阳性的男性被转诊至泌尿外科；其他男性则根据PSA水平被安排2年或5年的召回。到2025年6月，8558名男性登记（参与率8.7%），6072名符合条件；644名（10.6%）报告家族史呈阳性。在接受检测的人中，58.4%的人PSA<1 ng/mL且家族史为阴性，25.8%的人PSA>1且<3 ng/mL且家族史为阴性，15.9%的人符合转诊标准。数字分流效率高，确保了护理的连续性，且不会给专科医生带来负担。参与情况因当地卫生当局（ATS）而异，取决于实施背景。初步数据显示，与标准护理相比，泌尿外科会诊减少了25.9%，磁共振成像（MRI）使用减少了35%，活检率没有增加。该试点证明了数字化、风险分层前列腺癌筛查的技术可行性、安全性、低管理负担和潜在可持续性。虽然没有主动邀请时参与率较低，但早期结果支持通过改进外展工作进行推广。伦巴第大区的经验为意大利及其他寻求在早期检测与资源效率之间取得平衡的卫生系统提供了一个可扩展、符合欧盟标准的模式，以供更广泛实施。
