Homelessness and Cancer Prevention: Three Years of Experience with the CANCERLESS Project

Introduction: Cancer care delivery is complex given the multifaceted nature of cancer and the involvement of diverse professionals. Accessing cancer care for people experiencing homelessness (PEH) is a greater challenge due to specific barriers for this group. Therefore, primary, and secondary cancer preventive care among this population is crucial. Target audience: The CANCERLESS project presents valuable insights for policymakers, professionals, and academics invested in understanding integrated cancer care for PEH. Involvement of Stakeholders in the Project: Active participation of various stakeholders defined the CANCERLESS project, focusing on co-designing the Health Navigator Model (HNM), a cancer prevention intervention. Stakeholders included PEH, health and care professionals, and managers. Perspectives from all groups were systematically integrated into the implementation evaluation, employing the Consolidated Framework for Implementation Research (CFIR) and The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) frameworks. Intervention: The CANCERLESS project addresses the implementation gap in the HNM for PEH, aiming to increase awareness and cancer prevention and screening in Austria, Greece, the United Kingdom, and Spain. The HNM strategically positions individuals with health and social care backgrounds to identify the health needs of PEH, raise cancer awareness, and facilitate healthcare access. Results: Implementation science frameworks guide the evaluation of the HNM for cancer prevention among PEH. Results from this evaluation are anticipated to be available in February 2024. Expected outcomes are that the model is cost-effective and the implementation strategies. The insights gained will inform future implementations, improvements to the model, adoption, and policy recommendations. Lessons Learned for the International Audience: The HNM emerges as a promising intervention to alleviate the cancer burden for PEH by enhancing awareness, empowerment, and healthcare accessibility. This will ultimately facilitate and contribute to Europe’s Beating Cancer Plan, a framework for equitable access to quality cancer care across Europe. Its adaptability and implementation address unique challenges across diverse local contexts, offering valuable lessons for an international audience grappling with similar issues in homeless healthcare. Next Steps: Implementing the HNM signifies a groundbreaking approach to navigating health and care systems, particularly for those in dire need. Scaling this intervention to actual health and care systems is an objective for the consortium, expanding its scope beyond prevention and screening to encompass the entire cancer care pathway for PEH.