Which are the individual determinants of (non-)engaging behaviours in cancer screenings?

Abstract Background To sustain cancer screening programs for all citizens, individual barriers and facilitators influencing participation need to be identified and addressed, even more in the post-pandemic scenario. Methods In the European Joint Action EUCanScreen, building on a data-driven approach, a case study uses evidence from the Italian Behavioural Risk Factor Surveillance System PASSI on adults since 2007 to show how individual determinants apply for screening against cervical, breast and colorectal cancers. Results PASSI data 2022-2023 show that, in Italy, 77.5% of women aged 25-64 engaged with Pap- or HPV- test: 46.4% within organised programs and 31% spontaneously; being targeted by two interventions combined, invitation letter and advice, resulted the most effective intervention (87.3%). Reasons reported by non-complying women were mostly personal, such as no need (22.1%), no time (14.9%), laziness (13.7%), and related to organizational issues, e.g., no invitation (15.1%) or no advice (8.1%). According to PASSI data 2022-2023, 72.9% of women aged 50-69 preventively screened for breast cancer, by public programs (52.5%) or privately (20.1%), whereas one out of ten did not comply at all and another 20% did over the recommended timing (two years); even in this case, personal drivers’ weight doubled organizational lacks. The national coverage for the colorectal cancer screening is increasing since 2010 but still low in Italy: in 2022-2023, it reached 46.3% of older adults (aged 50-69). Both the most supporting factors as invitation letter combined with medical advice (67.7%) and the same barriers in determining non-participation recurred: no need (27.7%), no advice (21.2%), laziness (12.0%), no time (11.5%), no invitation (10.8%). Conclusions As indicated by European and National Cancer Plans, it is important to enhance population compliance with screening programs but also healthy lifestyles to make secondary and primary prevention evolve and adapt synergically. Key messages • It is crucial to identify barriers and facilitators influencing participation to cancer screenings. • Health promotion interventions need to be synergic including actions for primary and secondary prevention.