Mapping existing hospital-based cancer prevention pathways in Europe: insights from EUnetCCC

Background

Cancer remains a leading cause of morbidity and mortality in Europe, yet prevention is still poorly integrated into health and care systems. Hospitals and Comprehensive Cancer Centres (CCCs) have strong potential to deliver and coordinate prevention activities, but structured hospital-based pathways remain limited. Within the Joint Action EUnetCCC, we aim to map hospital-based cancer prevention pathways in Europe, describing their models and level of integration within healthcare systems.

Methods

We conducted a scoping review following PRISMA-ScR guidelines. The study was structured according to a PCC framework, including hospitals and cancer centres, delivering primary and secondary cancer prevention pathways, examining their organizational models and policy frameworks, across European Economic Area countries, UK, and Switzerland. We searched PubMed, Scopus, Google Scholar, existing networks and organizations’ websites, with no time limits.

Results

Preliminary findings show limited availability of structured hospital-based cancer prevention pathways. 88% of interventions focus on secondary prevention, 33% on primary prevention, with some studies reporting both. Breast and lung cancer are the main targets (22% each). Pathways address smoking (44%) through cessation programs, genetic/familial predisposition (33%) through counselling, infections (22%) through vaccination. Strengths include awareness campaigns, multidisciplinary collaboration, and improved access to early detection; challenges include low participation, workforce shortages, access inequalities, and limited hospital–community integration.

Conclusions

Hospital-based cancer prevention pathways are emerging across Europe but remain unevenly implemented, due to regional/national models where prevention occurs outside hospitals and reimbursement systems prioritize care. Strengthening structured pathways and prevention hubs could improve equity and enhance the impact of cancer prevention.

Key messages

• In Europe there are limited examples of hospitals that embed cancer prevention in routine care pathways.

• Mapping barriers and facilitators of hospital prevention pathways can inform implementation of cancer prevention models in cancer centers.