{"id":"https://openalex.org/W7223663399","doi":"https://doi.org/10.1093/eurpub/ckag169.1863","title":"Mammographic screening effectiveness in reducing breast cancer mortality in Sicily, Italy, 2008\u20132023","display_name":"Mammographic screening effectiveness in reducing breast cancer mortality in Sicily, Italy, 2008\u20132023","publication_year":2026,"publication_date":"2026-10-01","ids":{"openalex":"https://openalex.org/W7223663399","doi":"https://doi.org/10.1093/eurpub/ckag169.1863"},"language":"en","primary_location":{"id":"doi:10.1093/eurpub/ckag169.1863","doi":"https://doi.org/10.1093/eurpub/ckag169.1863","is_oa":true,"landing_page_url":"https://doi.org/10.1093/eurpub/ckag169.1863","pdf_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.1863/72465620/ckag169.1863.pdf","source":{"id":"https://openalex.org/S4210220588","display_name":"European Journal of Public Health","issn_l":"1101-1262","issn":["1101-1262","1464-360X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["abdc-b","anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"European Journal of Public Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.1863/72465620/ckag169.1863.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5159606977","display_name":"M La Bella","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I246010334","display_name":"Universit\u00e0 degli Studi di Enna Kore","ror":"https://ror.org/04vd28p53","country_code":"IT","type":"education","lineage":["https://openalex.org/I246010334"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"M La Bella","raw_affiliation_strings":["Specialty School in Public Health, University Kore of Enna , Enna,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Specialty School in Public Health, University Kore of Enna , Enna,","institution_ids":["https://openalex.org/I246010334"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159653156","display_name":"S Scondotto","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I246010334","display_name":"Universit\u00e0 degli Studi di Enna Kore","ror":"https://ror.org/04vd28p53","country_code":"IT","type":"education","lineage":["https://openalex.org/I246010334"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"S Scondotto","raw_affiliation_strings":["Specialty School in Public Health, University Kore of Enna , Enna,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Specialty School in Public Health, University Kore of Enna , Enna,","institution_ids":["https://openalex.org/I246010334"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159637748","display_name":"W Pollina Addario","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210114272","display_name":"Regione Siciliana","ror":"https://ror.org/025079t78","country_code":"IT","type":"government","lineage":["https://openalex.org/I4210114272"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"W Pollina Addario","raw_affiliation_strings":["Department of Health and Epidemiological Observatory, Sicillian Health Authority , Palermo,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Health and Epidemiological Observatory, Sicillian Health Authority , Palermo,","institution_ids":["https://openalex.org/I4210114272"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159605017","display_name":"L Li Sacchi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210114272","display_name":"Regione Siciliana","ror":"https://ror.org/025079t78","country_code":"IT","type":"government","lineage":["https://openalex.org/I4210114272"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"L Li Sacchi","raw_affiliation_strings":["Department of Health and Epidemiological Observatory, Sicillian Health Authority , Palermo,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Health and Epidemiological Observatory, Sicillian Health Authority , Palermo,","institution_ids":["https://openalex.org/I4210114272"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159600557","display_name":"A Cernigliaro","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210114272","display_name":"Regione Siciliana","ror":"https://ror.org/025079t78","country_code":"IT","type":"government","lineage":["https://openalex.org/I4210114272"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"A Cernigliaro","raw_affiliation_strings":["Department of Health and Epidemiological Observatory, Sicillian Health Authority , Palermo,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Health and Epidemiological Observatory, Sicillian Health Authority , Palermo,","institution_ids":["https://openalex.org/I4210114272"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159707028","display_name":"A Cristaldi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I246010334","display_name":"Universit\u00e0 degli Studi di Enna Kore","ror":"https://ror.org/04vd28p53","country_code":"IT","type":"education","lineage":["https://openalex.org/I246010334"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"A Cristaldi","raw_affiliation_strings":["Specialty School in Public Health, University Kore of Enna , Enna,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Specialty School in Public Health, University Kore of Enna , Enna,","institution_ids":["https://openalex.org/I246010334"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5159606557","display_name":"V Restivo","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I246010334","display_name":"Universit\u00e0 degli Studi di Enna Kore","ror":"https://ror.org/04vd28p53","country_code":"IT","type":"education","lineage":["https://openalex.org/I246010334"]}],"countries":["IT"],"is_corresponding":true,"raw_author_name":"V Restivo","raw_affiliation_strings":["Specialty School in Public Health, University Kore of Enna , Enna,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Specialty School in Public Health, University Kore of Enna , Enna,","institution_ids":["https://openalex.org/I246010334"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5159606557"],"corresponding_institution_ids":["https://openalex.org/I246010334"],"apc_list":{"value":2815,"currency":"EUR","value_usd":3181},"apc_paid":{"value":2815,"currency":"EUR","value_usd":3181},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.79826744,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"36","issue":"Supplement_5","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10556","display_name":"Global Cancer Incidence and Screening","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10556","display_name":"Global Cancer Incidence and Screening","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11361","display_name":"Digital Radiography and Breast Imaging","score":0.002199999988079071,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13544","display_name":"Women's cancer prevention and management","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/screening-mammography","display_name":"mammography screening","score":0.9760000109672546},{"id":"https://openalex.org/keywords/breast-cancer-mortality","display_name":"breast cancer mortality","score":0.9629999995231628},{"id":"https://openalex.org/keywords/screening-adherence","display_name":"screening adherence","score":0.8190000057220459},{"id":"https://openalex.org/keywords/health-equity","display_name":"health equity","score":0.7490000128746033},{"id":"https://openalex.org/keywords/sicily","display_name":"Sicily","score":0.7110000252723694},{"id":"https://openalex.org/keywords/southern-italy","display_name":"Southern Italy","score":0.718999981880188},{"id":"https://openalex.org/keywords/sociodemographic-barriers","display_name":"sociodemographic barriers","score":0.6069999933242798},{"id":"https://openalex.org/keywords/health-literacy","display_name":"health literacy","score":0.5379999876022339},{"id":"https://openalex.org/keywords/geographic-disparities","display_name":"geographic disparities","score":0.6100000143051147},{"id":"https://openalex.org/keywords/women-aged-50-69","display_name":"women aged 50-69","score":0.7689999938011169}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.775600016117096},{"id":"https://openalex.org/C530470458","wikidata":"https://www.wikidata.org/wiki/Q128581","display_name":"Breast cancer","level":3,"score":0.6434000134468079},{"id":"https://openalex.org/C147077947","wikidata":"https://www.wikidata.org/wiki/Q1515895","display_name":"Socioeconomic status","level":3,"score":0.6202999949455261},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.571399986743927},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.5436000227928162},{"id":"https://openalex.org/C2781354955","wikidata":"https://www.wikidata.org/wiki/Q11920938","display_name":"Marital status","level":3,"score":0.5059999823570251},{"id":"https://openalex.org/C2778491387","wikidata":"https://www.wikidata.org/wiki/Q17011492","display_name":"Breast cancer screening","level":5,"score":0.47450000047683716},{"id":"https://openalex.org/C2250968","wikidata":"https://www.wikidata.org/wiki/Q1512929","display_name":"Health equity","level":3,"score":0.4668000042438507},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.4325000047683716},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.42649999260902405},{"id":"https://openalex.org/C25511272","wikidata":"https://www.wikidata.org/wiki/Q295136","display_name":"Ecological study","level":3,"score":0.3698999881744385},{"id":"https://openalex.org/C38180746","wikidata":"https://www.wikidata.org/wiki/Q1952580","display_name":"Multivariate analysis","level":2,"score":0.3499999940395355},{"id":"https://openalex.org/C2778527826","wikidata":"https://www.wikidata.org/wiki/Q1787017","display_name":"Cancer registry","level":3,"score":0.3416999876499176},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.3402000069618225},{"id":"https://openalex.org/C179755657","wikidata":"https://www.wikidata.org/wiki/Q58702","display_name":"Mortality rate","level":2,"score":0.32670000195503235},{"id":"https://openalex.org/C2781122314","wikidata":"https://www.wikidata.org/wiki/Q33973","display_name":"Sicilian","level":2,"score":0.32269999384880066},{"id":"https://openalex.org/C2780472235","wikidata":"https://www.wikidata.org/wiki/Q324634","display_name":"Mammography","level":4,"score":0.322299987077713},{"id":"https://openalex.org/C2776463041","wikidata":"https://www.wikidata.org/wiki/Q3044843","display_name":"Cancer screening","level":3,"score":0.31189998984336853},{"id":"https://openalex.org/C78491826","wikidata":"https://www.wikidata.org/wiki/Q3045352","display_name":"Social determinants of health","level":3,"score":0.3093000054359436},{"id":"https://openalex.org/C29374701","wikidata":"https://www.wikidata.org/wiki/Q1931388","display_name":"Cause of death","level":3,"score":0.3089999854564667},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.26660001277923584},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.2606000006198883},{"id":"https://openalex.org/C143095724","wikidata":"https://www.wikidata.org/wiki/Q515895","display_name":"Odds","level":3,"score":0.25380000472068787}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1093/eurpub/ckag169.1863","doi":"https://doi.org/10.1093/eurpub/ckag169.1863","is_oa":true,"landing_page_url":"https://doi.org/10.1093/eurpub/ckag169.1863","pdf_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.1863/72465620/ckag169.1863.pdf","source":{"id":"https://openalex.org/S4210220588","display_name":"European Journal of Public Health","issn_l":"1101-1262","issn":["1101-1262","1464-360X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["abdc-b","anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"European Journal of Public Health","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13698224","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13698224/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13698224/pdf/ckag169.1863.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Eur J Public Health","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1093/eurpub/ckag169.1863","doi":"https://doi.org/10.1093/eurpub/ckag169.1863","is_oa":true,"landing_page_url":"https://doi.org/10.1093/eurpub/ckag169.1863","pdf_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.1863/72465620/ckag169.1863.pdf","source":{"id":"https://openalex.org/S4210220588","display_name":"European Journal of Public Health","issn_l":"1101-1262","issn":["1101-1262","1464-360X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["abdc-b","anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"European Journal of Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"},{"id":"https://metadata.un.org/sdg/10","score":0.8974000215530396,"display_name":"Reduced inequalities"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7223663399.pdf","grobid_xml":"https://content.openalex.org/works/W7223663399.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7221077451","https://openalex.org/W7154111465","https://openalex.org/W3034985180","https://openalex.org/W2075753417","https://openalex.org/W7137896636","https://openalex.org/W2886195028","https://openalex.org/W2004441014","https://openalex.org/W4388524766","https://openalex.org/W3213543418","https://openalex.org/W2043462703"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Breast":[2],"cancer":[3,9,106,148,200],"is":[4,192],"the":[5,54,61,101,110,122,189,253],"leading":[6],"cause":[7],"of":[8,208,218,259,279],"death":[10],"among":[11,88,222],"women":[12,89,224],"globally.":[13],"In":[14,27,45],"Italy,":[15],"approximately":[16],"55,900":[17],"new":[18],"cases":[19],"and":[20,37,71,128,135,226,240],"15,500":[21],"deaths":[22],"were":[23,98,186],"recorded":[24],"in":[25,53,60,79,92,182,202,287],"2022\u20132023.":[26],"Sicily,":[28],"mammographic":[29,269,280],"screening":[30,48,77,126,190,197,270,281,289],"(MS)":[31],"adherence":[32,127,141,271],"persistently":[33],"falls":[34],"below":[35],"national":[36],"European":[38,227,254],"targets,":[39],"creating":[40],"a":[41,248,284],"health":[42,67],"equity":[43],"gap.":[44],"detail,":[46],"organised":[47,235],"participation":[49,96],"declined":[50],"by":[51,58,263],"10%":[52],"Southern":[55,80],"while":[56],"increasing":[57,288],"6.6%":[59],"Northern":[62],"[1].":[63],"Barriers":[64],"including":[65],"limited":[66],"literacy,":[68],"geographic":[69],"disparities":[70],"socioeconomic":[72],"factors":[73],"continue":[74],"to":[75,243],"undermine":[76],"effectiveness":[78,278],"regions.":[81],"Methods":[82],"An":[83],"ecological":[84,228],"study":[85],"was":[86,142,167],"conducted":[87],"aged":[90],"50\u201369":[91],"Sicily":[93],"(2008\u20132023).":[94],"MS":[95,140],"rates":[97],"derived":[99],"from":[100,109],"PASSI":[102],"surveillance":[103],"system;":[104],"breast":[105,147,199,273],"mortality":[107,149,201,220,261,274],"data":[108],"Sicilian":[111],"Regional":[112],"Cancer":[113,255],"Mortality":[114],"Registry.":[115],"A":[116],"multivariate":[117],"logistic":[118],"regression":[119],"analysis":[120],"evaluated":[121],"association":[123],"between":[124],"annual":[125,232],"mortality,":[129],"adjusting":[130,160],"for":[131,161],"cohabitation,":[132],"educational":[133],"level,":[134],"marital":[136],"status.":[137],"Results":[138],"Higher":[139],"independently":[143],"associated":[144],"with":[145,215,252],"reduced":[146],"(OR":[150,170],"=":[151,157,171,177],"1.04;":[152],"95%":[153,173],"CI:":[154,174],"1.01\u20131.08;":[155],"p":[156,176],"0.043),":[158],"after":[159,234],"all":[162],"sociodemographic":[163,209],"covariates.":[164],"Calendar":[165],"year":[166],"also":[168],"significant":[169],"1.15;":[172],"1.03\u20131.29;":[175],"0.016),":[178],"reflecting":[179],"secular":[180],"improvements":[181],"treatment.":[183],"Sociodemographic":[184],"covariates":[185],"non-significant":[187],"suggesting":[188],"effect":[191],"not":[193],"confounded.":[194],"Conclusions":[195],"Organised":[196],"reduces":[198,272],"historically":[203],"underserved":[204],"Mediterranean":[205],"regions,":[206],"independent":[207],"factors.":[210],"Our":[211],"findings":[212],"are":[213],"concordant":[214],"EUROSCREEN":[216],"estimates":[217],"25\u201331%":[219],"reduction":[221,262],"invited":[223],"[2],":[225],"studies":[229],"showing":[230],"1.5\u20138.1%":[231],"reductions":[233],"programme":[236],"implementation":[237],"[3].":[238],"Structural":[239],"social":[241],"barriers":[242],"equitable":[244],"access":[245],"must":[246],"become":[247],"political":[249],"priority,":[250],"consistent":[251],"Beating":[256],"Plan":[257],"target":[258],"15%":[260],"2030.":[264],"Key":[265],"messages":[266],"\u2022":[267,276],"The":[268,277],"cancer.":[275],"should":[282],"be":[283],"key":[285],"factor":[286],"adherence.":[290]},"counts_by_year":[],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2026-10-27T00:00:00"}
