Mammographic screening in San Marino remains annual. Health Secretary of State Massimo Andrea Ugolini reaffirmed this today before the Fourth Commission: “The frequency is annual and we are continuing with this approach.” The confirmation, however, has not ended the political debate. The opposition claims this represents a retreat from a planned shift to two-year checks. The government and majority counter that the programme has never been altered.
The point of contention lies in what had been floated in previous weeks. Emanuele Santi (Rete) argues that the objectives assigned to the Radiology department already include a shift to biennial screening and a reduction in mammograms of at least 25 per cent compared with 2025. For the councillor, this is therefore not merely a scientific deep-dive. He is demanding explanations for the subsequent reaffirmation of annual checks and raises the question of the relationship between public service and private provision.
Matteo Casali (RF) takes particular issue with how health leadership has communicated the matter, and with the concern caused by references to possible risks linked to the frequency of exams. “It is not for us to decide whether the frequency should be annual or biennial: the scientific evidence must determine that,” he says. He is nonetheless seeking clarity on the method followed and on whether cost-saving needs played any role.
Gaetano Troina (D-ML), backed by all opposition forces, is calling for annual screening to be maintained throughout the review process, for the study to be made transparent, and for any future changes to be tied to documented scientific evidence. Troina clarifies that he is not asking for a deadline to be set on the research, which must be given the time it needs.
For Guerrino Zanotti (Libera), these safeguards already exist. He maintains that the health director, Bertolini, had outlined a review of the San Marino model without announcing any changes. “It was reaffirmed that the screening frequency is annual, no one has announced any changes, and it was stated that a medical-scientific study will be launched to further verify its effectiveness.”
Ugolini clarified that the study will run for five years, will involve the Epidemiological Observatory, and will subsequently be examined by the Bioethics Committee. The stated goal is to scientifically assess the model adopted in San Marino. The secretary dismissed alarm over any change to the programme: “If we are doing politics, we must give the technical experts the chance to do their job properly, continue the study, carry out prevention, and reassure our fellow citizens.”
On the matter of Radiology waiting lists, Ugolini pointed to shift rotations, new organisational arrangements, additional services and possible new resources. He denied any move towards privatisation and stressed the need to guarantee responses within the ISS [Social Security Institute], without forcing citizens to turn to private providers.
In closing, Casali returned to the need for internal checks into the handling of the matter and into statements that, in his view, had caused alarm among women in the Republic. “Politics cannot substitute for medicine or science, but it must point the way forward.”
Andrea Ugolini (PDCS), speaking on behalf of the majority, rejected the opposition’s interpretation and defended the independence of scientific assessments. “The Executive Committee is not backtracking on any decisions, because it never moved forward on them in the first place.” The opposition’s motion was rejected by 8 votes to 3.
