Italians were voting Sunday in one of the most uncertain elections in years and one that could determine if Italy succumbs to the populist, euroskeptic and far-right sentiment that has swept through Europe.

Many waited in line for more than an hour to vote, only to then be baffled by confusing ballots and the process to cast them — which for the first time required an anti-fraud check by polling authorities.

"You feel as if you have gone there prepared but it's not that clear," complained Sister Vincenza as she cast her ballot on Rome's Aventine hill before heading to Mass.

Some polling stations remained closed in Palermo two hours into election day because the wrong ballots were delivered and 200,000 new ones had to be reprinted overnight. Similar ballot glitches were reported elsewhere, forcing the suspension of the vote in two towns in Alessandria.

More than 46 million people were eligible to vote Sunday, including Italians abroad who already mailed in their ballots. Exit polls were expected after polls closed at 11 p.m. (2200 GMT; 5 p.m.), projections sometime thereafter and consolidated results Monday.

Italy's political scene is dominated by three main blocs — the center-right coalition, center-left coalition and the anti-establishment 5-Star Movement.

The campaign itself was marked by the prime-time airing of neo-fascist rhetoric and anti-migrant violence that culminated in a shooting spree last month against six Africans. While the center-right coalition that capitalized on Italy's anti-migrant sentiment has led the polls, analysts predict the likeliest outcome of Sunday's vote is a hung parliament.

With unemployment at 10.8 percent and economic growth in the eurozone's third-largest economy lagging the average, many Italians have all but given up hope for change. Polls indicated a third hadn't decided or weren't even sure they would vote.

"The situation is pretty bad," said Paolo Mercorillo from Ragusa, Sicily, who said he would not even bother casting a ballot. "There aren't candidates who are valid enough."

The 5-Star Movement hoped to capitalize on such disgust, particularly among Italy's young, and polls indicated the grassroots movement launched in 2009 by comic Beppe Grillo with the mantra for Italy's political establishment to "(expletive)-off" would be the largest vote-getter among any single party.

But the 5-Stars weren't expected to win enough to govern on their own, and they have sworn off forming coalitions. Still, the movement's leader, 31-year-old Luigi Di Maio, has recently suggested he would be open to talking with potential allies.

Analysts predict the only coalition with a shot of reaching an absolute majority is the center-right coalition anchored by former Premier Silvio Berlusconi's Forza Italia party and which includes the anti-migrant League and the nationalistic, neofascist-rooted Brothers of Italy party.

A topless Femen activist confronted Berlusconi on Sunday, jumping on a table as he was about to hand in his ballot and displayed "Berlusconi, you've expired" on her bare torso.

Berlusconi, 81, can't run for office because of a tax fraud conviction, but he has tapped European Parliament President Antonio Tajani, considered a pro-European moderate, as his pick if the center-right is asked to form a government.

League leader Matteo Salvini is also gunning for the top job, and some pro-European analysts envisioned a possible "nightmare scenario" of an extremist alliance among the 5-Stars, the League and Brothers of Italy.

The presence in Rome this weekend of Steve Bannon, right-wing populist architect of Donald Trump's White House campaign, was an indication of the stakes.

"I think if they create a coalition among all the populists it would be fantastic, it would terrify Brussels and pierce it in its heart," Bannon was quoted as saying in Sunday's Corriere della Sera.

Roberto D'Alimonte of Rome's LUISS University said such an outcome would be "catastrophic" for the markets. But he said the 5-Stars will have to decide if they're going to join the right or the left if they're going to move from the opposition to actually help govern.

"This will be the moment of truth," he said.

With polls showing the center-left trailing, Democratic Party leader Matteo Renzi and the current premier, Paolo Gentiloni, spent the final days of the campaign warning that the only way to guard against a turn to populists and extremists was to vote for the Democrats.

Because Renzi alienated so many in the coalition, Gentiloni has been cited as a possible candidate for premier.

A new law passed last year, ostensibly to make Italy more governable, calls for a combination of direct and proportional voting for both the lower Chamber of deputies, which has 630 seats, and the Senate, which has 315 seats.

A few quirks could affect the outcome, particularly for the 5-Stars.

For starters, the names of about a dozen 5-Star candidates will appear on the ballot, but they no longer represent the party. If they actually win, other parties can woo them away to beef up their own ranks.

Analysts have also warned the ballot itself is confusing and could result in a higher-than-usual percentage of invalid votes.

While European capitals and Brussels were watching the outcome for its effects on policy and markets, some in Italy had more at stake personally. Berlusconi has vowed to deport 600,000 migrants if the center-right wins.

"Yes indeed, I fear these results, because I have arrived here with all my thoughts and dreams," said Musab Badur, an asylum-seeker from Sudan who is living in a Milan shelter. "And I never thought that one day maybe I would have to go back."