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Cancer Screening and Primary Care

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Epidemiology and Prevention".

Deadline for manuscript submissions: closed (31 January 2026) | Viewed by 10302

Special Issue Editor


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Guest Editor
Division of Cancer Control and Population Sciences, University of Puerto Rico, San Juan, PR, USA
Interests: cancer health disparities; infection-related cancers; social determinants of health (SDoHs)

Special Issue Information

Dear Colleagues,

Cancer screening in primary care plays a pivotal role in the early detection and prevention of malignant neoplasms, significantly reducing cancer-related morbidity and mortality. As the first point of contact for most patients, primary care providers (PCPs) are uniquely positioned to implement population-based screening strategies, ensuring equitable access and adherence in diverse demographics. Population-based analysis provides critical information on effectiveness, reach, and disparities in cancer screening programs, enabling targeted interventions to optimize cancer outcomes.

Screening programs for common cancers, such as breast, cervical, colorectal, prostate, anal, and lung cancer, rely on robust integration into primary care to achieve the timely identification of at-risk individuals and to facilitate follow-up care and management. Cancer screening has been shown to reduce mortality from some of the most common cancers. However, despite significant efforts to promote evidence-based cancer screening, challenges persist, including disparities in screening rates based on socioeconomic status, insurance, race/ethnicity, gender identity, disability, education, age, sexual orientation, geographic location, and psychosocial, cultural, and other factors. Furthermore, to balance the benefits of early detection with potential negative aspects, such as overdiagnosis and false positives, evidence-based guidelines should be tailored to specific populations.

This Special Issue will explore the intersection of cancer screening and primary care, emphasizing the role of population-based analysis in identifying social determinants of health and current gaps, informing policy, and improving the effectiveness of cancer screening initiatives. This can improve public cancer health outcomes such as incidence, prevalence, mortality, morbidity, stage at diagnosis, survivorship, and the financial burden of cancer or related health conditions.

Dr. Marievelisse Soto-Salgado
Guest Editor

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • screening amenable cancers
  • screening
  • primary care
  • disparities in cancer care
  • cancer outcomes

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Published Papers (6 papers)

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Research

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16 pages, 387 KB  
Article
Qualitative Outcomes of Colorectal Cancer Screening Outreach Using Patient Navigation to Follow-Up Colonoscopy in Rural Primary Care Practices
by Emily Myers, Jennifer Coury, Maryan Carbuccia-Abbott, Amanda F Petrik, Robert Durr, Jamie H Thompson, Erin S Kenzie, Gloria D Coronado and Melinda M Davis
Cancers 2025, 17(21), 3590; https://doi.org/10.3390/cancers17213590 - 6 Nov 2025
Cited by 1 | Viewed by 1308
Abstract
Background/Objectives: Despite its effectiveness, colorectal cancer (CRC) screening rates are suboptimal in the United States. Navigating patients towards complete CRC screening can be effective in addressing barriers. However, to date, much research on patient navigation has occurred in urban settings or large health [...] Read more.
Background/Objectives: Despite its effectiveness, colorectal cancer (CRC) screening rates are suboptimal in the United States. Navigating patients towards complete CRC screening can be effective in addressing barriers. However, to date, much research on patient navigation has occurred in urban settings or large health systems, thereby missing some populations that could benefit the most. Methods: We report on a patient navigation program delivered by clinic staff during a large pragmatic study to improve CRC screening in rural Medicaid populations. We use qualitative and implementation data from interviews, contract logs, and tracking systems to explore the context, barriers, and facilitators of patient navigation, as well as feasibility and acceptability for rural primary care clinic partners. Results: A total of 35 patients were eligible for navigation following an abnormal FIT (n = 26, 74%) or due to higher CRC risk (n = 9, 24%); only 8 of the 14 intervention clinics (57%) had any eligible patients. Of the 26 patients who needed navigation following an abnormal FIT, 13 patients (50%) received navigation, and 3 (23%) completed a colonoscopy; all 9 of the higher-risk patients received navigation, but none completed colonoscopy. Several barriers impacted adherence to the navigation protocol, such as staffing disruptions, limited colonoscopy availability, patient mistrust, and data tracking limitations. Our findings also highlight implementation facilitators, including protocol adaptations and cross-team collaborations for low-volume settings. Conclusions: Future models to increase patient navigation in rural settings could include more centralized system-level interventions that build on relationships between clinics and colonoscopy providers or payers and leverage quality improvement best practices. Full article
(This article belongs to the Special Issue Cancer Screening and Primary Care)
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15 pages, 253 KB  
Article
Characteristics of Participants and Findings of the National Breast Cancer Early Detection Program in Saudi Arabia
by Fatina Al Tahan, Shaker A. Alomary, Hani Tamim, Mohammad Alkaiyat, Haifa Nassri, Khaled Alkattan and Abdul Rahman Jazieh
Cancers 2025, 17(21), 3403; https://doi.org/10.3390/cancers17213403 - 22 Oct 2025
Cited by 2 | Viewed by 1804
Abstract
Globally, around 2 [...] Full article
(This article belongs to the Special Issue Cancer Screening and Primary Care)
15 pages, 354 KB  
Article
The Effectiveness of ¡Salud!, por la Vida, an Educational Intervention to Increase Colorectal Cancer Screening in Puerto Rico
by Josheili Llavona-Ortiz, Maria E. Fernández, Ileska M. Valencia-Torres, Francisco J. Muñoz-Torres, Marievelisse Soto-Salgado, Yara Sánchez-Cabrera and Vivian Colón-López
Cancers 2025, 17(20), 3391; https://doi.org/10.3390/cancers17203391 - 21 Oct 2025
Viewed by 1236
Abstract
Background/Objectives: Colorectal cancer (CRC) is the leading cancer-related death in Puerto Rico (PR). Yet CRC screening (CRCS) rates remain low. We developed ¡Salud!, por la Vida, an educational intervention aiming to increase CRCS among age-eligible adults living in PR. Methods: [...] Read more.
Background/Objectives: Colorectal cancer (CRC) is the leading cancer-related death in Puerto Rico (PR). Yet CRC screening (CRCS) rates remain low. We developed ¡Salud!, por la Vida, an educational intervention aiming to increase CRCS among age-eligible adults living in PR. Methods: We conducted a cluster randomized controlled trial among adults 50–75 years old at Federally Qualified Health Clinics in PR. Participants could not have a history of CRC nor be currently adherent to CRCS guidelines for a fecal occult blood test (FOBT) or fecal immunochemical test (FIT) (within last year) or colonoscopy (within last 5–10 years). Out of 445 randomized participants, 355 completed the study procedures (Control: 277; Intervention: 78) and were included in the main analysis. Participants in the intervention arm completed baseline and follow-up questionnaires alongside the educational intervention (at baseline) and two reminder calls (before follow-up) within a four-month period. Control arm participants only completed baseline and follow-up questionnaires within the same period. All participants were followed up to assess CRCS completion. Results: Post-trial screening rates were significantly higher in the intervention group: FOBT/FIT (55% vs. 39%, p = 0.02), colonoscopy (10% vs. 3%, p = 0.02), and any CRCS (60% vs. 41%, p < 0.01). Compared to controls, those in the intervention group showed a 48% higher probability of undergoing any CRCS (RR = 1.48, 95%CI: 1.17, 1.86), were 1.4 times more likely to complete a FOBT/FIT (RR = 1.40, 95%CI: 1.09, 1.80), and were over 3 times more likely to undergo a colonoscopy (RR = 3.16, 95%CI: 1.26, 7.91). Conclusions: The findings underscore the efficacy of the intervention in increasing CRCS uptake, potentially preventing late-stage detection and reducing CRC mortality in PR. Full article
(This article belongs to the Special Issue Cancer Screening and Primary Care)
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18 pages, 826 KB  
Article
Iterative Situated Engagement Perspective: Meaning-Making Challenges Across Cancer Screening Phases
by Daniela Lemmo, Maria Luisa Martino, Roberto Bianco, Anna Rosa Donizzetti, Maria Francesca Freda and Daniela Caso
Cancers 2025, 17(12), 2007; https://doi.org/10.3390/cancers17122007 - 16 Jun 2025
Cited by 1 | Viewed by 1252
Abstract
Background/Objectives:Breast and cervical cancer screening programs are essential for early detection and timely treatment, yet participation rates remain suboptimal. Within a patient-centered care approach, engagement is increasingly viewed as a dynamic and emotionally grounded process. The literature conceptualizes three phases of engagement [...] Read more.
Background/Objectives:Breast and cervical cancer screening programs are essential for early detection and timely treatment, yet participation rates remain suboptimal. Within a patient-centered care approach, engagement is increasingly viewed as a dynamic and emotionally grounded process. The literature conceptualizes three phases of engagement in healthcare decision-making: ‘recruit’, ‘retain’, and ‘sustain’. When these phases intersect with the structured pathway of cancer screening, they generate specific meaning-making challenges that shape how women relate to prevention and care. This study adopts the lens of Iterative Situated Engagement (ISE) to explore how women experience and negotiate these challenges, differentiating them across the three engagement phases. Methods: A theory-driven qualitative design was adopted. Data were collected through semi-structured interviews with 40 women aged 25–69 years participating in public breast and cervical cancer screening programs. Thematic analysis was conducted using the Framework Method. Results: In the ‘recruit’ phase, engagement was driven by Cancer Risk Monitoring, Self-care Motivation, Fear of Death Management, and Coincidence. The ‘retain’ phase emphasized Trust in Healthcare Providers, Accessibility of Services, Recurrent Invitations, and Informal Result Previews. About the ‘sustain’ phase, Continuity of Healthcare Providers, Driving Best Practices Dissemination, Flexible Organization of Healthcare Services, and Shorter Waiting Times for Results were highlighted as key factors in maintaining engagement over time. Conclusions: Women’s engagement in cancer screening emerges as a dynamic, multi-phase process shaped by psychological, emotional, and organizational levels. These findings contribute to the development of the ISE conceptual proposal, which frames participation as an iterative, situated, and meaning-making trajectory. Strengthening personalized health communication and improving the coordination of primary care services could enhance sustained participation in screening programs, supporting strategies to reduce health disparities and promote preventive practices. Full article
(This article belongs to the Special Issue Cancer Screening and Primary Care)
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Review

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19 pages, 367 KB  
Review
Endometrial Hyperplasia: Current Insights into Epidemiology, Risk Factors, and Clinical Management
by Apostolia Galani, Sofoklis Stavros, Efthalia Moustakli, Anastasios Potiris, Athanasios Zikopoulos, Ismini Anagnostaki, Konstantinos Zacharis, Maria Paraskevaidi, Deirdre Lyons, Stefania Maneta-Stavrakaki, Nikolaos Thomakos, Maria Kyrgiou and Ekaterini Domali
Cancers 2026, 18(1), 148; https://doi.org/10.3390/cancers18010148 - 31 Dec 2025
Cited by 1 | Viewed by 1781
Abstract
Endometrial hyperplasia (EH) comprises a spectrum of abnormal proliferative changes in the endometrium, ranging from benign glandular overgrowth to lesions with substantial malignant potential. The importance of risk stratification and early identification is highlighted by the growing recognition of EH as a precursor [...] Read more.
Endometrial hyperplasia (EH) comprises a spectrum of abnormal proliferative changes in the endometrium, ranging from benign glandular overgrowth to lesions with substantial malignant potential. The importance of risk stratification and early identification is highlighted by the growing recognition of EH as a precursor to endometrial cancer. The main causes of EH, according to epidemiological research, include obesity, polycystic ovarian syndrome (PCOS), metabolic dysfunction, and extended exposure to unopposed estrogen. Emerging molecular markers, histological analysis, and imaging are all necessary for a proper diagnosis of EH because it might appear with vague clinical symptoms such as irregular uterine bleeding. Surgical intervention or progestin therapy are two possible management techniques for EH, depending on the lesion’s intricacy and the patient’s medical history, including fertility issues. Personalized therapy techniques and recent developments in molecular profiling have the potential to enhance patient outcomes by matching treatment to tumor biology and individual risk profiles. This review highlights the translational potential of molecular insights while synthesizing the most recent data on the epidemiology, risk factors, diagnostic techniques, and therapy of EH. A deeper comprehension of these elements is necessary to maximize treatment results and stop the development of endometrial cancer. Full article
(This article belongs to the Special Issue Cancer Screening and Primary Care)
17 pages, 1058 KB  
Review
Expanding Cancer Prevention: Strategies Integrated into Occupational Health Surveillance
by Giulia Collatuzzo, Alessandro Godono, Giulia Fiorini, Daniel Vencovsky, Stefano Giordani, Valentina Biagioli, Felipe Augusto Pinto-Vidal, Monireh Sadat Seyyedsalehi, Magdalena Kostrzewa, Angel Honrado, Daniele Bruno, Adonina Tardon, Dana Mates, Anna Schneider-Kamp, Eleonora Fabianova and Paolo Boffetta
Cancers 2025, 17(21), 3535; https://doi.org/10.3390/cancers17213535 - 31 Oct 2025
Cited by 3 | Viewed by 1454
Abstract
Participation in cancer prevention programs is suboptimal. Socioeconomic backgrounds play a role in cancer awareness and prevention programs. We conducted a narrative review, summarizing the evidence on the integration of cancer prevention extended to non-occupational risk factors at the workplace. Cancer prevention programs [...] Read more.
Participation in cancer prevention programs is suboptimal. Socioeconomic backgrounds play a role in cancer awareness and prevention programs. We conducted a narrative review, summarizing the evidence on the integration of cancer prevention extended to non-occupational risk factors at the workplace. Cancer prevention programs include screenings (colonoscopy, mammography, Pap-test), vaccinations (anti-HPV, anti-HBV), and interventions focused on lifestyle changes. Such strategies may face several barriers related to individual or environmental factors. The workplace is potentially an ideal setting for implementing extended cancer prevention strategies because (i) occupational health surveillance (OHS) targets adults, including hard-to-reach subgroups; (ii) it is structured, with health records and exams for risk assessment; (iii) it offers a key chance to promote cancer awareness and prevention through direct worker–physician interaction. Such an innovative approach requires a coordinated effort to build professional networks and manage high-risk workers. Its successful implementation depends on financial support and the active involvement of physicians, employers, and workers. Occupational-based cancer prevention represents a novel and promising strategy, though its feasibility and cost-effectiveness need to be assessed through large-scale studies. Full article
(This article belongs to the Special Issue Cancer Screening and Primary Care)
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