Cancer screening is a key preventive strategy in primary care, enabling early detection and improved outcomes. In XXX, national cancer screening programs are provided free of charge; however, participation rates remain below recommended levels. Identifying determinants of screening uptake is essential to strengthen primary care–based prevention strategies.To assess the frequency of cancer screening uptake and to explore factors associated with participation in national cancer screening programs among adults aged 50–65 years in a primary care setting.This descriptive cross-sectional study was conducted among adults aged 50–65 years registered with family health centers in the city center of XXX, XXX. A total of 401 participants were included. Data were collected through face-to-face interviews using a structured questionnaire assessing sociodemographic characteristics, cancer screening–related knowledge, attitudes, and behaviors. Descriptive statistics and comparative analyses were performed. Statistical significance was set at p<0.05.The mean age of participants was 56.45±4.59 years, and 49.1% were women. Overall, 44.1% of participants reported having undergone at least one cancer screening test. Screening uptake was significantly higher among individuals who had received a screening recommendation (p<0.001), particularly from family physicians. The most common reason for screening participation was physician recommendation (54.2%), whereas lack of knowledge (37.9%) and fear of receiving bad news (35.3%) were the main reasons for non-participation. Female sex, being married, engaging in regular or partial physical activity, abstaining from alcohol, and having a first-degree relative with cancer were significantly associated with screening uptake. Participants who had undergone screening demonstrated significantly higher knowledge and attitude scores compared to those who had not (p<0.05).The findings underline the pivotal role of family physicians in influencing cancer screening behaviors. Both informational gaps and emotional barriers continue to limit screening uptake, despite the availability of organized national programs.Cancer screening participation among adults aged 50–65 years remains suboptimal. Strengthening proactive recommendations, patient-centered counseling, and continuity of care in primary care settings may substantially improve uptake of national cancer screening programs.

Prostate cancer (PCa) is the most common cancer among men in the UK, with a disproportionate impact on those from Black African and Caribbean backgrounds. Black men are twice as likely to develop PCa, experience more aggressive disease progression, and are 2.5 times more likely to die from it than their White counterparts. They are diagnosed at a younger age and present to their family doctor at later stages. Black men are more likely to be diagnosed with advanced disease, and the survival gap compared to White men continues to widen. Despite these challenges, Black men are less likely to receive treatments that are proven to be their best chance of cure and report poorer healthcare experiences compared to White men.Our study identified barriers and facilitators to PCa healthcare in UK Black men and suggests ways to improve engagement and experiences across the healthcare pathway.We conducted semi-structured interviews with:   (i) 12 UK Black men living with and beyond PCa,  (ii) 15 UK Black men aged 45 or above,  (iii) 15 UK multi-disciplinary healthcare professionals (HCPs).  Interview transcripts were coded and analysed thematically, using the socioecological model to map barriers and facilitators.We found that barriers to access and engagement with PCa care included mistrust of Western medicine, experiences of racism, fear and stigma around PCa, inadequate culturally sensitive information, underrepresentation of Black HCPs and Black men in healthcare spaces, limited culturally sensitive psychological support, and masculinity constructs affecting open discussions and preferences for minimally invasive treatments. Facilitators include racially concordant HCPs, culturally sensitive care, continuity of care, and support from partners, peers, and community groups.Internalised, interpersonal, and systemic racism undermine Black men’s experiences and engagement with PCa care, contributing to delays in care-seeking, reduced treatment engagement, and poorer healthcare experiences. By mapping barriers and facilitators from the macro to the micro level, we highlight the need for multi-level interventions that address how these forms of racism intersect and compound challenges across the care pathway.Providing culturally sensitive information, care from racially concordant HCPs, and community support can enhance Black men’s survivorship experiences and engagement with healthcare.

Prostate cancer remains a prevalent malignancies among men worldwide, with 10–20% of cases in high-income countries and up to 60% in parts of Europe still diagnosed at advanced stages. Traditional early-detection pathways in primary care—principally prostate-specific antigen (PSA) testing, digital rectal examination (DRE), and transrectal ultrasound (TRUS)–guided biopsy—are limited by low specificity, patient discomfort, and high refusal rates for invasive steps. These challenges contribute to incomplete screening cascades and delayed diagnosis. Growing evidence suggests that multiparametric magnetic resonance imaging (mpMRI) may offer a more acceptable and accurate first-line examination.To review the literature evaluating whether mpMRI improves adherence to prostate cancer early detection compared with traditional methods and whether an MRI-first strategy may reduce false positives, minimize unnecessary biopsies, and enhance diagnostic outcomes in primary care settings.A narrative literature review was conducted using PubMed, Scopus, and Web of Science (2015–2024). Search terms included prostate cancer, screening, adherence, digital rectal examination, TRUS, mpMRI, and early detection. Inclusion criteria: peer-reviewed studies, meta-analyses, randomized trials, guideline statements, and implementation pilots evaluating diagnostic accuracy, patient acceptance, or screening outcomes. Exclusion criteria: imaging protocols, treatment-focused studies, or incomplete datasets. Findings were synthesized thematically.Across studies, DRE refusal ranged from 8–22%, and TRUS-biopsy refusal from 15–30%, representing a significant barrier to early detection. PSA-based strategies produced high false-positive rates, with up to 75% of elevated PSA results not indicating cancer. mpMRI demonstrated higher sensitivity and specificity for clinically significant disease and consistently reduced unnecessary biopsies through targeted sampling. Real-world data (e.g., PROMIS, PRECISION trials; PRAISE-U pilot programs) showed high patient uptake of MRI and improved identification of clinically meaningful lesions. However, long-term evidence on population-level mortality benefit for MRI-first screening remains limited.The literature suggests that mpMRI may mitigate adherence barriers created by invasive traditional steps, while improving diagnostic discrimination and reducing overdiagnosis. Implementation feasibility depends on resource availability, radiological expertise, and equitable access.Evidence supports mpMRI is more acceptable and diagnostically advantageous early-detection tool. While not yet validated as a universal first-line screening method, an MRI-first approach shows promise for improving adherence and reducing late diagnosis, warranting further prospective evaluation in primary care.

Evidence regarding the incidence of fractures among lung cancer (LC) survivors remains limited.We assessed the fracture risk in LC survivors who underwent curative-intent surgery, stratified by cancer treatment modalities and postoperative time.A retrospective, population-based cohort study was conducted utilizing the Korean National Health Insurance Service database (2009–2022). The study included LC survivors (n = 33,292) and 1:3 age- and sex-exactly matched controls (n = 99,876). Competing risk analyses were performed, with all-cause mortality considered as a competing risk.We found that LC survivors had an elevated risk of fractures compared to non-cancer controls during the overall follow-up, with a particularly increased risk of vertebral (cause-specific hazard ratios [csHRs] 1.81, 95% confidence interval [CI] 1.45–2.26) and hip fractures (csHR 1.40, 95% CI 0.98–1.98) within the first year following surgery, after which the risk decreased. The risk of any fracture was prominent in LC survivors receiving radiation therapy (RT) (csHR 1.78, 95% CI 1.43–2.23) or chemoradiotherapy (CRT) (csHR 1.73, 95% CI 1.50–1.99).We identified an elevated risk of fractures among LC survivors compared to non-cancer participants throughout the entire follow-up period, with especially heightened risks for vertebral and hip fractures observed during the first year post-surgery, followed by a subsequent decline. Factors such as the extent of surgical intervention and the presence of pre-existing pulmonary disease may contribute to extended hospital stays or reductions in physical activity, increasing susceptibility to weight loss, sarcopenia, or falls. Our findings highlight the importance of comprehensive management strategies, with particular attention to LC survivors who received RT or CRT.LC survivors exhibited a consistently greater risk of fractures compared to non-cancer controls, with a substantially higher risk of both vertebral and hip fractures during the initial year after surgery among those treated with RT or CRT.

Colorectal cancer (CRC) is a common cancer with a poor prognosis if detected late. The participation in screening program remains insufficient. Our study was ancillary to the FACELE study, a pragmatic randomized controlled trial investigating the superiority of training general practitioners (GPs) in a patient-centered approach to implement shared decision-making (SDM) in CRC screening program.The objective of our study was to explore the understanding and adoption of SDM by patients, pharmacists and GPs in CRC screening program.We conducted three qualitative studies using an approach inspired by the grounded theory. The interviews were individual. The sample was constructed using theoretical purposive sampling. The data were manually coded with triangulation of the analysis.Eleven interviews were conducted for each population group between May 2024 and March 2025. Patients' approaches to SDM varied depending on their stance towards care, ranging from directive to compliant, debating to distant. Although SDM appeared to play only a limited role in CRC screening program, the overall approach of SDM was recognized by all patients, albeit heterogeneous. The use of SDM did not systematically imply a balanced final decision. Pharmacists wear many hats, from technician to treating physician, including verifier, distributor, informant, and advocate. They did not readily adopt the concept of SDM within the context of CRC screening program. Despite their desire to persuade, respecting patients' refusals and their free will remained paramount. GPs widely adopted SDM and personalized it: there wasn't one SDM, but several SDM, applied at different stages of the consultation. SDM and the GP's role could be at odds, particularly regarding their "savior" role.The main strength of this study lies in the plurality of perspectives. The variety of definitions of SDM is consistent with the literature. This study highlighted the advantages of multidisciplinary collaboration and the importance of consistent training for all healthcare professionals.The concept of SDM remains unclear for its various stakeholders, sometimes seen as a lever or a hindrance in CRC screening program. They each use it in their own way, but always with the aim of prioritizing the caregiver-patient relationship and promoting patient empowerment.

Lung cancer screening (LCS) using low-dose computed tomography (LDCT) has the potential to reduce mortality through detection in an early, asymptomatic stage. Despite its proven effectiveness, implementation remains limited in Belgium, where currently no uniform screening program exists. General practitioners (GPs) play a critical role in promoting screening uptake, yet various physician-related barriers may hinder this process.Identify general physician related obstacles to lung cancer screening in the french and german speaking regions of Belgium.This thesis was conducted in two phases. First, a scoping review was performed using PubMed to identify physician, patient and healthcare system related obstacles to cancer screening across various cancer types, namely lung, colorectal, breast and cervical cancer. 79 articles published between 2019 and 2024 in English, French, and German were included. From this review, 22 physician-related barrier themes were extracted. Secondly, these themes informed the development of an online questionnaire targeting GPs in the French and German speaking regions of Belgium to identify priority barriers for countermeasures. The survey assessed GP-perceived barriers to LCS, opinions concerning LCS, and factual knowledge of current screening guidelines.The online survey yielded 43 valid responses. The top three barriers, consistent across both frequency and strength of endorsement, were the inability to bill separately for LCS counselling (100%), non-use of shared decision-making (SDM) tools (94.6%), and lack of use of risk evaluation tools (91.9%). Knowledge questions revealed that while most participants correctly identified LDCT as the appropriate screening method, only 34.9% were aware of the correct screening interval (1 year), and just 37.2% identified correct pack-year eligibility thresholds. A total of 80.5% expressed a need for more training to feel confident in recommending LCS.-This study highlights key physician-related barriers to the implementation of LCS in (French and German speaking) Belgian general practice. The findings suggest a strong need for targeted educational interventions, better integration of SDM and risk evaluation tools, and systemic adaptations such as billing reforms. While exploratory in nature due to the limited sample size, these insights provide a foundation for future interventions aimed at improving LCS uptake and supporting GPs in evidence-based screening practices.

This Health Center serves 19 villages surrounding a small town. Cervical cancer screening coverage in the area has been very low, and vaccine hesitancy has been rising, including due to misinformation. This project aimed to increase Pap smear testing and readiness to receive HPV vaccination.Prior to the project, many village women faced transport barriers, had limited knowledge about cervical cancer, and rarely attended the Center for screening. The team (director, gynecology nurse, family nurse, village nurses, and family doctor) therefore organized scheduled village visits to conduct Pap smear tests on site. Concurrently, group lectures and individual conversations were held to raise awareness about cervical cancer and the HPV vaccination. Challenges included severe weather conditions, registration errors, low public awareness, misinformation (internet, social media), and incomplete data.It is important to ensure a team's mutual trust and respect. The same project and approach may not work everywhere and should be adapted to local contexts. Stakeholders should be engaged early to ensure trust and buy in within the community. The standardization of this process in the Center, with the strategic involvement of the different members of the healthcare team, will ensure its sustainability.As a result of the intervention, Pap smear screening rate increased from less than 1% in 2024 to almost 13% in the first 9 months of 2025. More parents reported understanding of the importance of the HPV vaccination of their 13-year-old daughters. Completed data for 2025 will be included in the final poster.Reaching rural communities requires different strategies than the typical approach.This project demonstrated how team-based community outreach can improve participation in screening and patient education, contributing to cervical cancer prevention and reducing future burden on the healthcare system.