Objective: To understand the adhesion rate and the features of women adherent to breast cancer (BC) screening test, an essential secondary prevention tool in early diagnosis and mortality reduction.

Participants and Methods: We evaluated the adhesion of a group of target women aged 50-69, living in the provincial territory of Messina, Italy, in the five-year period 2018-2022. Specifically, we calculated the adhesion and the positivity rate through the analyses of electronic registries of the local Provincial Health Agency. Then, we investigated some features of the adherent women in order to understand which factors could be involved in the attitude to be screened. In particular, the counselling forms filled during the screening were examined and data about some well-known risk factors such as age, familiarity, number of children and breastfeeding were evaluated.

Results: The overall adhesion rate was very poor (24.5% of the invited women) with a mean positivity rate (i.e. confirmed BC) of 8%. Especially in the group of older women we detected the lower adhesion rate (18.6%). A high percentage (28%) of screened women declared a familiarity for BC. BC positivity was directly associated with age and familiarity, and inversely with number of children and breastfeeding.

Conclusions: Our findings suggest that familiarity for BC is the major motivation to be screened, especially for women with a certain awareness to be at risk; indeed, they are more inclined to adhere to mammogram screening. A strengthening of women’s awareness about all the protective and risk factors for the BC development through mass media and the involvement of healthcare professionals could improve the situation, increasing the compliance to screening campaigns, especially among older women.