Adherence to Cancer Screening Guidelines in Employer-Provided Healthcare Programs: A Survey of Companies in Lombardy (Northern Italy)
Francesco Scovenna, Paola Ballotari, Sara Piccinelli, Andrea Pedot, Francesca Ferrè, Valentina Barbera, Corrado Celata, Nadia Vimercati, Elena Tettamanzi, Fabrizio Ernesto Pregliasco, Danilo Cereda, Silvia DeandreaObjectives
Organized, population-based cancer screening is recommended by European Union guidelines. Employer-provided screening within Workplace Health Promotion (WHP) programs may differ from evidence-based guidelines. This study aimed to evaluate the alignment between international cancer screening recommendations and screening services offered by companies participating in the Lombardy WHP Program.
Methods
A cross-sectional survey was conducted between April and September 2024 among companies participating in the Lombardy WHP Program. Screening practices for breast, cervical, colorectal, prostate, and lung cancer were compared with the most recent international guidelines. Company characteristics were analyzed using descriptive statistics and univariate logistic regression models.
Results
Of the 308 companies participating in the survey, 95 reported the inclusion of preventive medicine services in their corporate welfare offer. Among these, breast cancer screening was the most frequently offered service (67.4%), followed by cervical cancer screening (57.9%). Both the majority of mammography offers (51%) and Pap test offers (92.6%) were not guideline-adherent, thus resulting in overscreening. Colorectal cancer (41.1%) and lung cancer (33.7%) screening were even less commonly provided by the participating companies. Prostate cancer screening with PSA testing was available in 63.2% of participating companies. Large companies had significantly lower odds of inappropriate mammography intervals (OR 0.11; 95% CI 0.02–0.58).
Conclusion
Cancer screening services offered by companies, compliant with the Lombardy WHP Program, are frequently not aligned with current evidence-based recommendations, with overscreening emerging as a predominant issue. Strengthening coordination between occupational health services and public health authorities is essential to ensure appropriate, equitable, and sustainable integration of workplace-based screening initiatives into organized regional cancer prevention strategies.