Stakeholders’ role in cancer primary prevention: qualitative evidence from 9 European countries

Abstract Background Cancer Primary Prevention (CPP) is a cost-effective strategy to tackle high cancer incidence rates, through modifiable risk factors (e.g., smoking or exposure to pollution). This study aims to characterize the current and potential role of different stakeholders in CPP. Methods Semi-structured interviews were conducted (n = 33, 9 European countries) with stakeholders from the 5 sectors of the penta-helix approach (public sector, academia/research, private sector, media and civil society). Participants were selected through purposive sampling and asked about their CPP activities, motivations, barriers and opportunities, and the role of other sectors. Thematic analysis was used to identify overarching themes and key concepts for each sector. Results The public sector ("Strategy") is considered responsible for citizens’ health, providing structure for CPP initiatives, and engaging in operational activities. Academia/research ("Knowledge") is associated with scientific credibility, obtained through diverse and multidisciplinary approaches. While its role is influenced by academic environments, there is potential implementing findings in society. The private sector ("Responsibility") seems focused on obtaining profit, while providing resources to develop CPP activities. This sector prompted calls for more ethical corporate practices. Media ("Dissemination") has a large capacity to reach people, to disseminate specific news or general messages about health promotion. Diverse channels are available, but concerns exist about the quality of information. Civil society's proximity to people ("Engagement") strengthens its capacity to advocate and bridge gaps from other sectors, though efforts may lack formality and structure. Conclusions CPP goes beyond the actions of governments. A multi-sectoral approach is desired in order to unravel the full potential of CPP decreasing the burden of cancer. Key messages • As Cancer Primary Prevention goes beyond governmental actions, a multi-sectoral approach may be required to unravel CPP’s full potential. • There are complementary roles from the public sector (Strategy), academia/research (Knowledge), private sector (Responsibility), media (Dissemination) and civil society (Engagement).