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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: 31 January 2026 | Viewed by 1678

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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Keywords

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

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Published Papers (3 papers)

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Research

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 (registering DOI) - 22 Oct 2025
Abstract
Introduction: Breast cancer remains the most common cancer among women in Saudi Arabia and is often diagnosed at advanced stages due to delays in screening. This study aimed to examine the characteristics of women participating in a national breast cancer screening program, identify [...] Read more.
Introduction: Breast cancer remains the most common cancer among women in Saudi Arabia and is often diagnosed at advanced stages due to delays in screening. This study aimed to examine the characteristics of women participating in a national breast cancer screening program, identify the predictors of positive mammography findings, and assess the potential association between body mass index (BMI) and breast cancer risk. Methods: Data were obtained from the Saudi National Breast Cancer Early Detection Program that ran from May 2013 to July 2016. The study included Saudi women aged 30 years and older who underwent screening mammography and clinical breast examination. Demographic, clinical, and reproductive data were collected, and multivariable logistic regression analysis was used to determine the predictors of a positive mammogram and breast cancer diagnosis. Results: A total of 8348 women were screened (median age: 50 years), with 60 cases of breast cancer detected (detection rate: 7.4 per 1000). Most participants were either self-referred (62.4%) or referred by health educators (30.9), and 29.5% were illiterate. Oral contraceptive use was more common among women with breast cancer compared to those without (78.3% vs. 64.2%, p = 0.02), and the duration of use was significantly longer (median: 84 vs. 60 months, p = 0.041). However, in multivariable analysis, only abnormal findings on clinical breast examination were significantly associated with a positive mammogram (OR 21.3, 95% CI 7.9–57.1, p < 0.0001), but no independent association was found between BMI and breast cancer. Conclusions: The national screening program demonstrated a strong detection rate, with clinical breast examination being the only independent predictor of a positive mammogram. Larger studies including more breast cancer patients with longer follow-ups are needed to further investigate the influence of BMI and hormonal factors on breast cancer risk in Saudi women. 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
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
Viewed by 818
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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