Unaccompanied foreign minors: the Novara experience as a reference center of Eastern Piedmont (Italy)

Background: 20% of migrants who reach Italy are minors, often Unaccompanied Foreign Minors (UFM). If they are minors, they have the right to remain on EU territory, but in case of doubt, the authorities ask to ascertain their age. This is currently done through different procedures. Methods: The aim of this study was to understand the validity of the protocol adopted by the ‘Maggiore della Carità hospital in Novara (Italy), reference center for Eastern Piedmont, for ascertaining the age of self-proclaimed minors by comparing the results with those of other European realities. A cross-sectional study was conducted by analyzing the final reports of UFM examined at this hospital between January 1st, 2018, and December 31st, 2023. Socio-demographic, clinical, radiological and forensic data were collected. Results: Three hundred and one migrants were evaluated: 97% was male with an average age reported of 16.32 years ± 1.35. The estimated age by wrist X-ray was 17.81 ± 1.52. The physical examination of sexual maturation was not statistically correlated with the age estimated by X-rays (r = 0.36). No migrant was certified as an adult. Pathologies and injuries were frequently described. Conclusion: Comparing these results with those of similar European studies, it seems that the Piedmont protocol is unable to accurately estimate the age, even though it is one of the most complete Italian one. The effort to assign an age as close as possible to the actual one is a prerequisite for recognizing the rights of these individuals, but the method must achieve concrete and decisive results without violating their integrity.