Introduction:
In Italy in 2020, 2,400 new cases of cervical cancer were diagnosed, equal to 1.3% of all cancers occurring in women. Even though organized cervix screening was part of the Italian Essential Levels of Assistance (LEA), it was not actively offered in Lombardy Region, where opportunistic screening was more widespread. Instead, an active papillomavirus vaccination campaign was in place. This study aims to describe the public health strategies adopted in the Lombardy Region to revamp cervical cancer prevention.

Methods:
To achieve this goal, crucial regulatory acts were implemented. Some of these are: - Issue of the Regional Prevention Plan 2021-2025 (DGR 5389 of 18/10/2021). - Inclusion of screening programs among the performance evaluation objectives of the General Directors of the Health Protection Agencies (ATS) and the Local Social Healthcare Agencies (ASST) (DGR 5832 of 29/12/2021) - Creation of the “Regional Oncological Screening Multidisciplinary Coordination” and of the “Cervix Working Group” (Decree 2125 of 22/02/2022) - Launch of the primary screening pilot project for the prevention of cervical cancer using self-collected sampling combined with the HPV test (DGR 7435 of 11/30/2022)

Results:
As a result of the above actions, significant results were obtained: * Primary prevention goal: active invitation of the 1997 cohort to vaccination on their first screening appointment, which led to a 32.4% vaccination coverage in this cohort * Secondary prevention goal: 153,703 invitations to HPV screening * Issue of a guidance document covering all aspects of the screening pathway, from laboratory to follow-up management

Conclusions:
The Lombardy Region has successfully initiated the screening for cervical cancer with ongoing roll-out, expecting a complete invitation coverage in few years. New goals in perspective include expanding the free offer of the vaccine to young women between 18 and 25 years of age and increasing overall immunization coverage.