Roxo Luis, Santos Ana, Girvalaki Charis, Geantă Marius, Sousa-Uva Mafalda
Department of Epidemiology, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal.
Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal.
Front Public Health. 2025 Jul 16;13:1550712. doi: 10.3389/fpubh.2025.1550712. eCollection 2025.
Cancer incidence has been increasing in Europe, with stark disparities between Western and Eastern regions. Cancer primary prevention (CPP) is a cost-effective strategy tackling lifestyle and risk factor exposure, but its implementation goes beyond the actions of the governments. This study aims to characterize stakeholders' role in CPP, using a penta-helix approach, with the objective of shedding a new light in the Iron Curtain of Cancer Cases.
We followed a mixed-methods approach, with quantitative and qualitative data from CPP stakeholders from the public sector, academia/research, private sector, media and civil society. Snowball sampling was used to distribute a survey where participants ( = 110) were asked which sector was the main driver of change, the most proactive and the most influential. Purposive sampling was used for semi-structured interviews ( = 33), where stakeholders were asked about their CPP activities, motivations, barriers and opportunities, and the role of other sectors. Countries were coded as Western or Eastern. Descriptive analysis was used for quantitative data, while thematic analysis was used for qualitative data.
The public sector is viewed as the main driver of change, and the most proactive and influential in both Western and Eastern Europe. However, Eastern European countries emphasize the role of other sectors in CPP more strongly. Thematic analysis identified key roles and themes for the public sector (Strategy: "Looking after citizen's health," "Making the system work," "Operational Engagement"), academia/research (Knowledge: "Scientific credibility," "Diversity of approaches," "Getting out of the lab," "Life in academia/research"), private sector (Responsibility: "Profit-oriented," "Resources and operational activities," "Ethics and responsibility"), media (Dissemination: "Capacity to reach people," "Diversity and scope," "Information and dissemination") and civil society (Engagement: "Proximity to people," "Advocacy and voice," "Do what others do not do"). Although no meaningful differences were identified between Western and Eastern countries, the results highlight opportunities for Eastern countries to reduce regional disparities.
Overall, results point to the complementary role of the sectors, emphasizing that involving different stakeholders and promoting adequate collaborations between them is crucial to unravel the full potential of CPP.
欧洲癌症发病率一直在上升，西部地区和东部地区之间存在明显差异。癌症一级预防（CPP）是一项应对生活方式和风险因素暴露的具有成本效益的策略，但其实施超出了政府的行动范围。本研究旨在采用五螺旋方法描述利益相关者在癌症一级预防中的作用，以期为癌症病例的“铁幕”带来新的启示。
我们采用了混合方法，收集了来自公共部门、学术界/研究机构、私营部门、媒体和民间社会的癌症一级预防利益相关者的定量和定性数据。采用滚雪球抽样法进行一项调查（n = 110），询问参与者哪个部门是变革的主要驱动力、最积极主动的部门和最具影响力的部门。采用目的抽样法进行半结构化访谈（n = 33），询问利益相关者他们的癌症一级预防活动、动机、障碍和机遇，以及其他部门的作用。国家被编码为西部或东部。定量数据采用描述性分析，定性数据采用主题分析。
公共部门被视为变革的主要驱动力，在西欧和东欧都是最积极主动且最具影响力的。然而，东欧国家更加强调其他部门在癌症一级预防中的作用。主题分析确定了公共部门（战略：“照顾公民健康”、“使系统运转”、“运营参与”）、学术界/研究机构（知识：“科学可信度”、“方法多样性”、“走出实验室”、“学术界/研究机构的生活”）、私营部门（责任：“以利润为导向”、“资源和运营活动”、“道德与责任”）、媒体（传播：“接触人群的能力”、“多样性和范围”、“信息与传播”）和民间社会（参与：“贴近人群”、“倡导与发声”、“做他人不做之事”）的关键作用和主题。虽然在西方国家和东方国家之间未发现有意义的差异，但结果突出了东方国家减少地区差异的机遇。
总体而言，结果表明各部门具有互补作用，强调让不同利益相关者参与并促进他们之间的充分合作对于发挥癌症一级预防的全部潜力至关重要。
