Preventive healthcare measures

Vaccinations

The Italian National Health Service (SSN) provides 10 mandatory vaccinations for minors aged between 0 and 16 years, and for unaccompanied foreign minors (Decree-Law No 73 of 7 June 2017, amended by Conversion Law No 119 of 31 July 2017):

• polio
• diphtheria
• tetanus
• hepatitis B
• whooping cough (pertussis)
• Haemophilus influenzae type B
• measles
• rubella
• mumps
• chickenpox.

Compulsory vaccinations are free of charge and must be carried out in accordance with the vaccination calendar. For information on vaccination centres, please contact your local health authority.

Recommended vaccinations provided in accordance with the vaccination calendar and ministerial provisions, such as the vaccinations against influenza (flu), HPV, etc., are also free of charge.

More information: Vaccinations by age, category and condition

School and vaccinations

In order to enrol your children in kindergarten or preschool in Italy, regardless of their nationality or registered residence, preliminary vaccination is required with at least the mandatory vaccinations (Decree-Law No 73 of 7 June 2017, as amended by Conversion Law No 119 of 31 July 2017). If children or young people from primary (elementary) school onwards are enrolled without fulfilling the obligations, the local health authority will implement a vaccination catch-up programme and may require you to pay an administrative fine of EUR 100 to EUR 500.

Exemptions from mandatory vaccination programmes apply for children and young people who already have natural immunity following illness, and for children with documented clinical conditions that represent a permanent and/or temporary contraindication to vaccination, certified by a general practitioner or paediatrician of their choice.

Cancer screening

Cancer screening programmes are public health interventions in which the healthcare system actively, freely and systematically offers an organised course of secondary prevention to detect cancer or its precursors at an early stage, thus allowing for timely intervention.

The main objective of the screening programmes is to reduce tumour mortality through early diagnosis. In the field of oncology (tumours), early diagnosis is essential to increase the effectiveness of treatment and the possibility of recovery.

The SSN offers cancer screening to people in age groups considered, on the basis of scientific evidence, to be at higher risk of developing the disease.

There are three active cancer screening programmes:

• Screening for breast cancer
• Screening for cervical cancer
• Screening for colorectal cancer

The activity and development of screening programmes is monitored through data transmitted by each regional programme to the National Screening Observatory (Osservatorio Nazionale Screening – ONS).

Citizens of screening age will receive – depending on the procedures in place for the programme in their region – a letter or a phone call inviting them to take the test and indicating the associated procedures, times and places.

Screening for breast cancer

If you are a woman aged between 50 and 69, screening is performed with a mammogram every two years.

In some regions, efficacy is being tested for a wider age group of between 45 and 74 years (annually for women under 50 years).

Screening for cervical cancer

If you are a woman aged between 25 and 64, you will be offered a cervical smear test every three years.

This makes it possible to identify very early cancerous lesions.

It involves taking a sample of a small quantity of cells from the cervix, which are then analysed. If there are no anomalies, you can repeat the test three years later. If anomalies are detected, you will be invited to undergo further testing.

Given the role of certain types of HPV virus (which are considered high-risk) in the development of cervical cancer, the regions have recently been invited to introduce HPV tests as first-level tests in cervical screening.

The new screening test is based on analysis for high-risk HPV infection. The sampling process is similar to a cervical smear test. The examination should be carried out no earlier than 30 years of age and repeated at intervals of no less than five years. If the HPV test is positive, you will need to undergo a cervical smear test and potential further tests.

Screening for colorectal cancer

If you are aged between 50 and 69, you can be screened for colorectal cancer. Almost all testing programmes use faecal occult blood testing, which is performed every two years.

Faecal occult blood testing involves collecting a small sample of faeces at home, which is then analysed in a laboratory to find any traces of blood not visible to the naked eye. If any traces of blood are found, further clinical tests must be carried out.

Neonatal screening

In Italy, the Essential Levels of Care (Livelli Essenziali di Assistenza – LEA) guarantee all newborns the necessary and appropriate services for the early diagnosis of congenital diseases provided for by current legislation and clinical best practice, including for the early diagnosis of congenital deafness, congenital cataracts and inherited metabolic diseases.

These are important preventive measures, which are free of charge and mandatory.

Neonatal screening involves a non-invasive test that allows for the early identification of several congenital diseases that, if not diagnosed and treated in time, can cause mental and/or growth delays, serious permanent damage and, in some cases, death.

The test is a right for all newborns. It is performed on several drops of blood taken from the newborn’s heel and placed on a special card, and takes place between 48 and 72 hours after birth in the maternity unit before the child leaves the hospital.

In Italy, the neonatal blood spot test has been free of charge and mandatory since 1992 for three conditions: congenital hypothyroidism, cystic fibrosis and phenylketonuria (Law No 104 of 5 February 1992). In the years since, mandatory neonatal screening (screening neonatale obbligatorio – SNE) has been extended to about 40 inherited metabolic diseases, and was included in the new LEA (Law No 167 of 19 August 2016).

Relevant legislation

Vaccinations:

• Decree-Law No 73 of 7 June 2017 laying down urgent provisions on vaccination prevention
• Conversion Law No 119 of 31 July 2017 converting into law, with amendments, Decree-Law No 73 of 7 June 2017 laying down urgent provisions on vaccination prevention.

Neonatal screening:

• Law No 104 of 5 February 1992 ‘Framework law to enhance support, social integration and rights for people with disabilities’
• Law No 167 of 19 August 2016 ‘Provisions on mandatory neonatal diagnostic tests for the prevention and treatment of hereditary metabolic diseases’ with subsequent amendments and additions (2019 Budget Law, Article 1(544), amending Law No 167/2016 and extending screening to genetic neuromuscular diseases, severe congenital immunodeficiencies and lysosomal storage diseases)
• Decree of the Ministry of Health of 13 October 2016 ‘Provisions for the start-up of neonatal screening for the early diagnosis of hereditary metabolic diseases’ and Annex – List of conditions
• Prime Ministerial Decree of 12 January 2017 Determining and updating the essential levels of care laid down in Article 1(7) of Legislative Decree No 502 of 30 December 1992 (Article 38(2))