Mapping personalized risk-stratified prevention approaches: A JA PreventNCD Project scoping review

Abstract Background Personalized prevention is recognized for improving the effectiveness and equity of non-communicable diseases (NCD) interventions. Risk stratification tailors prevention to individual characteristics, but its consistent application remains unclear. Within the Joint Action PreventNCD we examine the scope and implementation of personalized risk-stratified recommendations. Methods We conducted a scoping review on strategies targeting major NCDs (cancer, cardiovascular diseases (CVDs), diabetes, chronic respiratory diseases, mental health conditions), based on stratification by tobacco use, physical inactivity, unhealthy diet, alcohol use, genetic factors. A tailored PCC framework guided the inclusion across contexts limited to recommendations, guidelines, consensus statements published from 2019 to 2024. Searches covered PubMed, Web of Science, Scopus and first 100 results from Google and Google Scholar. Results We extracted 769 approaches from 138 documents: 15.2% addressed primary prevention, 29.3% secondary, 55.5% tertiary. Cancer and CVDs were the most targeted (44.2% and 45.5%). A level of evidence to support formulation was reported in 62.5%, with 20.2% classified as high quality. Overall, stratification was mainly based on genetic factors (50.3%), followed by tobacco use (3.6%), unhealthy diet (2.5%), alcohol use (0.8%), physical inactivity (0.5%). Additionally, 34.7% were stratified only by disease presence exclusively for tertiary prevention. Only 7.5% applied a risk score combining multiple factors for risk stratification. Conclusions The integration of personalized approaches in prevention is increasing across different branches of medicine. Modifiable risk-based stratification is still underused, highlighting missed opportunities for early intervention. A shift toward more balanced, evidence-informed, actionable prevention strategies, particularly in primary and secondary prevention, is crucial to enhance equity and impact across populations. Key messages • Consideration of modifiable risk factors is important when developing risk-stratified personalized prevention approaches. • Recommendations should be based on strong evidence to ensure the effectiveness of interventions.