IM - ORIGINAL Attitude of the Italian general population towards prevention and screening of the most common tumors, with special emphasis on colorectal malignancies Federica Domati Æ Estratios Travlos Æ Claudia Cirilli Æ Giuseppina Rossi Æ Piero Benatti Æ Massimiliano Marino Æ Giovanni Ponti Æ Maria Vandelli Æ Simone Valmori Æ Amal Oursana Æ Annalisa Pezzi Æ Maurizio Ponz de Leon Received: 26 May 2008 / Accepted: 17 July 2008 / Published online: 20 September 2008 Ó SIMI 2008 Abstract Screening and early diagnosis of cancer repre- sent relatively recent tools in the long-lasting battle against tumors. If the American public opinion manifests its enthusiasm towards screening, the attitude of European is less well known. The purpose of the present study was to assess the level of knowledge and awareness of cancer screening (with particular emphasis on colorectal neo- plasms) among middle-aged individuals. The study group consisted of 945 healthy individuals (489 men, 456 women, average age 57 ± 12.4 years) who were asked to answer a series of questions about cancer screening and surveillance through a questionnaire presented by trained residents. Each interview lasted 20–30 min. Middle-aged Italians of both sexes seem to be aware of the fact that cancer is a frequent disease; moreover, many of the interviewed sub- jects believe almost all neoplasms are incurable. Diet, style of life, other environmental factors and familial factors are fully appreciated as relevant risk factors. The exact meaning of prevention was clear to less than half of the subjects. When various cancer sites were analyzed, the existence of preventive measures was well known for breast, cervical and prostate tumors, but their role was less clear for colorectal cancer. Only a fraction of the inter- viewed individuals were willing to undergo screening; the main reasons for refusal were lack of usefulness and fear of results. Among various tests, ultrasound and endoscopy were usually carried out in the presence of symptoms. Finally, multivariate analysis showed that the two factors significantly associated with the decision to undergo screening procedures were increasing age and level of education. The results of the study suggest that middle- aged Italian individuals, predominantly from Northern regions, have a correct perception of some aspects (fre- quency, risk factors) of cancer biology, whereas the knowledge of other aspects (outcome, prevention) remains poor or approximate. It follows that one of the main objectives of the Political Class should be to obtain a better education of overage individuals about cancer and the many problems related to this common disease. Keywords Cancer Á Prevention Á Screening Á Colonoscopy Á Sigmoidoscopy Á Hemoccult Introduction Despite the undoubted advancements in early diagnosis, molecular biology and treatment, malignant tumors con- tinue to represent one of the main causes of death, and a tremendous challenge for developed as well as for many emerging countries [1–3]. Among malignancies, colorectal tumors constitute a public health problem in all Western Countries, and their incidence tends to increase even in many developing populations [4, 5]. Since the natural history and the biological basis of intestinal neoplasms are rather well known—in particular, the role of genetics and F. Domati Á E. Travlos Á G. Rossi Á P. Benatti Á M. Marino Á G. Ponti Á M. Vandelli Á S. Valmori Á A. Oursana Á A. Pezzi Á M. Ponz de Leon Dipartimento di Medicina Interna, Universita ` di Modena e Reggio Emilia, Modena, Italy C. Cirilli Dipartimento di Oncologia ed Ematologia, Universita ` di Modena e Reggio Emilia, Modena, Italy M. Ponz de Leon (&) Dipartimento Integrato di Medicine e Specialita ` Mediche, Medicina I, Policlinico, Universita ` di Modena e Reggio Emilia, Via del Pozzo 71, 41100 Modena, Italy e-mail: deleon@unimore.it 123 Intern Emerg Med (2009) 4:213–220 DOI 10.1007/s11739-008-0184-5