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Straw C, Antelo VS, Paolino M, Murillo R, Espina C, Arrossi S. Acceptability, appropriateness and feasibility of the Latin American and Caribbean Code against Cancer: perceptions of decision-makers and health professionals in Argentina. Ecancermedicalscience 2022; 16:1375. [PMID: 35702416 PMCID: PMC9116998 DOI: 10.3332/ecancer.2022.1375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background Cancer is an important public health problem. In Latin America and the Caribbean, there were approximately 1,500,000 new cases of cancer and 700,000 deaths due to cancer in 2020. These figures will increase by 78% by 2040 to more than 2.5 million people diagnosed with cancer each year, who will require medical attention, care and support. However, it is estimated that at least 40% of cancers could be prevented by adopting a healthier lifestyle, reducing risky behaviours and implementing recommended health interventions. Objective To evaluate the perceptions of health decision-makers and professionals regarding the Latin American and Caribbean Code against Cancer (CLCC) as a support tool for designing and implementing public policies for cancer prevention and control (acceptability, appropriateness and feasibility) in Argentina. Methods A qualitative study was conducted using individual, semi-structured interviews with health decision-makers and professionals (n = 30). The questions and thematic analysis of the information gathered have been guided by the principles of the Consolidated Framework for Implementation Research: intervention characteristics, outer setting, inner setting and characteristics of individuals. Results Health professionals and health decision-makers broadly accepted the proposal of the CLCC as a tool for supporting the design and implementation of public policies for cancer prevention and control, and considered it to be appropriate. Additionally, from the interviewees' perspective, factors should be ensured to guarantee the implementation of the CLCC as a viable public health policy. They also felt it was right to take the CECC as a model and to adapt its content to the specific characteristics of the Latin American population, customs, lifestyle habits, epidemiological characteristics and, in particular, the Argentinian socio-economic context. Interviewees perceived the CLCC as a health intervention whose complexity varied depending on the recommendation, although most of them were feasible. The broad consensus among the interviewees was that the development of the CLCC could yield numerous advantages in improving cancer prevention and control policy, and responding to the needs of the population. It was also considered to be an opportunity to introduce fundamental changes. With regard to the implementation of the CLCC, interviewees reported a favourable institutional climate, since they perceived that it would receive a priority equal to or greater than the ongoing prevention measures, and that it would have the commitment of the health authorities. They also felt that the implementation of the CLCC in their work environment would not be very complicated, and that the decision-makers and professionals had the necessary capacity to implement it. Finally, they felt that the implementation would be facilitated by the participation and consensus of health decision-makers at the primary care level, and negotiation with industrial and environmental sectors. Conclusions Our study shows that health professionals and decision-makers consider the CLCC to be highly acceptable, appropriate and feasible. This would facilitate its implementation as a tool that could enhance current cancer prevention and control policies in Argentina. The results of the study indicate the necessity for the CLCC to be adapted to the socio-economic context of Argentina, and highlight that population adherence to the CLCC recommendations will depend on complex and diverse factors, especially those involving changing unhealthy behaviours linked to cancer risk.
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Affiliation(s)
- Cecilia Straw
- Faculty of Social Sciences, University of Buenos Aires, Santiago del Estero 1029, Buenos Aires 1075, Argentina
- Centre for the Study of State and Society, Sánchez de Bustamante 27, Buenos Aires 1193, Argentina
| | - Victoria Sánchez Antelo
- Centre for the Study of State and Society/National Council for Scientific and Technical Research, Sánchez de Bustamante 27, Buenos Aires 1193, Argentina
| | - Melisa Paolino
- Centre for the Study of State and Society/National Council for Scientific and Technical Research, Sánchez de Bustamante 27, Buenos Aires 1193, Argentina
| | - Raúl Murillo
- San Ignacio University Hospital, Kra 7 40-62, Bogotá, Colombia
| | - Carolina Espina
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon CEDEX 08, France
| | - Silvina Arrossi
- Centre for the Study of State and Society/National Council for Scientific and Technical Research, Sánchez de Bustamante 27, Buenos Aires 1193, Argentina
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Romero-Rodríguez E, Pérula-de Torres LA, Moscosio-Cuevas JI, Ruiz-Moral R, Jiménez-García C, Olaya-Caro I, Camarelles-Guillem F. Health-Related Lifestyles and Cancer-Preventive Behaviors of Medical and Nursing Students and Family Medicine Residents in Relation to the European Code Against Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:576-583. [PMID: 31848937 DOI: 10.1007/s13187-019-01667-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Family medicine (FM) residents and medical and nursing students play an important role in the development of preventive and health-promoting activities. The objective was to evaluate the health-related lifestyles and cancer-preventive behaviors of medical and nursing students and FM residents in relation to the European Code Against Cancer (ECAC). This was a descriptive, cross-sectional study performed in Spain. Medical and nursing students and FM residents completed a self-administered questionnaire focused on health-related habits and clinical behaviors related to the ECAC. A total of 740 participants completed the questionnaire. About 12.2% (95% CI [9.8-14.5]) were smokers, and 77.3% (95% CI [74.3-80.3]) sporadically consumed alcohol; 34.2% (95% CI [30.8-37.6]) practiced physical activity 2-3 times a week, and 12.1% (95% CI [9.8-14.5]) were overweight or obese. About 54.2% (95% CI [50.6-57.8]) regularly consumed vegetables. Differences were detected in the completion of screening tests for colorectal cancer (p < 0.001), breast cancer (p = 0.023), cervical cancer (p = 0.006), and prostate-specific antigen determination (p < 0.001) in relation to the participants' academic profiles. Our results reveal heterogeneous practices between the participants in terms of health-related habits. Awareness about the risks of smoking and being overweight were high; however, the perception of the risks associated with solar exposure and alcohol consumption was poor. There was general agreement upon the importance of performing screening tests for breast, cervical, and colorectal cancer, but there were discrepancies related to the need to perform the prostate cancer screening test.
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Affiliation(s)
- Esperanza Romero-Rodríguez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/, Hospital Reina Sofía/Universidad de Córdoba, Córdoba, Spain
- Boston University School of Public Health, Boston, MA, USA
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria de Córdoba, Córdoba, Spain
| | - Luis Angel Pérula-de Torres
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/, Hospital Reina Sofía/Universidad de Córdoba, Córdoba, Spain.
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria de Córdoba, Córdoba, Spain.
- Distrito Sanitario Córdoba y Guadalquivir, Córdoba, Spain.
| | - José Ignacio Moscosio-Cuevas
- Grupo de Evaluación y mejora del Programa de Actividades Preventivas y de Promoción de la Salud (PAPPS) de la Sociedad Española de Medicina Familiar y Comunitaria (semFYC), Barcelona, Spain
| | - Roger Ruiz-Moral
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/, Hospital Reina Sofía/Universidad de Córdoba, Córdoba, Spain
- Facultad de Medicina de la Universidad Francisco de Vitoria, Madrid, Spain
| | - Celia Jiménez-García
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/, Hospital Reina Sofía/Universidad de Córdoba, Córdoba, Spain
- Centro de salud Infanta Mercedes, Madrid, Spain
| | - Inmaculada Olaya-Caro
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/, Hospital Reina Sofía/Universidad de Córdoba, Córdoba, Spain
- Distrito Sanitario Córdoba y Guadalquivir, Córdoba, Spain
| | - Francisco Camarelles-Guillem
- Centro de salud Infanta Mercedes, Madrid, Spain
- Grupo de Educación para la Salud del PAPPS (semFYC), Barcelona, Spain
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Ritchie D, Mallafré-Larrosa M, Ferro G, Schüz J, Espina C. Evaluation of the impact of the European Code against Cancer on awareness and attitudes towards cancer prevention at the population and health promoters' levels. Cancer Epidemiol 2021; 71:101898. [PMID: 33611135 DOI: 10.1016/j.canep.2021.101898] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The European Code against Cancer (ECAC) informs the public on steps to take to reduce their cancer risk. Despite over three decades of promotion, no systematic evaluation of its impact has yet been carried out. This study aimed to address the gap in knowledge regarding the impact of the ECAC. METHODS An online survey targeting adults in the general population was conducted and analysed by age, gender, and country, both descriptive and mutually adjusted in logistic regression analyses. Additionally, semi-structured interviews with health promotion professionals from not-for-profit organisations in Europe were conducted and a qualitative thematic analysis was carried out for each interview. RESULTS 8171 people from eight European countries responded to the survey. Although 70 % of respondents were aware of cancer prevention guidance, a low percentage of participants had previously heard about the ECAC (2% in UK to 21 % in Hungary and Poland). Females were more likely to make lifestyle changes to reduce their risk of cancer (odds ratio = 1.17; 95 % confidence interval: 1.05-1.29). Twenty-eight online semi-structured interviews with professionals were conducted covering 25 countries. Regional variation in the methods and target groups of the promotion and dissemination of the ECAC was reported. CONCLUSION Whilst familiarity with the ECAC in the general public is low, professionals frequently use it as a basis for informing population-level actions. Future editions should be accompanied by a systematic evaluation of the ECAC investigating the impact upon society.
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Affiliation(s)
- D Ritchie
- Association of European Cancer Leagues (ECL), Chaussée de Louvain 479, Brussels, 1030, Belgium.
| | - M Mallafré-Larrosa
- Association of European Cancer Leagues (ECL), Chaussée de Louvain 479, Brussels, 1030, Belgium
| | - G Ferro
- International Agency for Research on Cancer/World Health Organization (IARC), 150 cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - J Schüz
- International Agency for Research on Cancer/World Health Organization (IARC), 150 cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - C Espina
- International Agency for Research on Cancer/World Health Organization (IARC), 150 cours Albert Thomas, 69372, Lyon CEDEX 08, France
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Pérula de Torres LÁ, Romero Rodríguez E, Moscosio Cuevas JI, Jiménez García C. [Degree of knowledge of the European Code against Cancer among university students, residents and health professionals of primary care]. Aten Primaria 2020; 52:287-289. [PMID: 31672250 PMCID: PMC7118574 DOI: 10.1016/j.aprim.2019.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 06/10/2019] [Accepted: 07/14/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Luis Ángel Pérula de Torres
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, España; Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Córdoba, España; Distrito Sanitario Córdoba y Guadalquivir, Córdoba, España; Grupo de Evaluación y mejora del Programa de Actividades Preventivas y de Promoción de la Salud (PAPPS) de la Sociedad Española de Medicina Familiar y Comunitaria (semFYC).
| | - Esperanza Romero Rodríguez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, España; Boston University School of Public Health, Boston, Massachusetts, EE. UU; Grupo de Evaluación y mejora del Programa de Actividades Preventivas y de Promoción de la Salud (PAPPS) de la Sociedad Española de Medicina Familiar y Comunitaria (semFYC)
| | - José Ignacio Moscosio Cuevas
- Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Córdoba, España; Grupo/Programa Comunicación y Salud de la semFYC
| | - Celia Jiménez García
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, España; Distrito Sanitario Córdoba y Guadalquivir, Córdoba, España
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Rocío OR, Macarena LL, Inmaculada SB, Antonio JP, Fernando VA, Marta GC, María-José S, José-Juan JM. Compliance with the 2018 World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations and Prostate Cancer. Nutrients 2020; 12:nu12030768. [PMID: 32183345 PMCID: PMC7146507 DOI: 10.3390/nu12030768] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/01/2020] [Accepted: 03/11/2020] [Indexed: 12/16/2022] Open
Abstract
The etiology of prostate cancer (PCa) remains largely unknown. Compliance with the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) cancer prevention recommendations and its relationship to PCa was evaluated. A total of 398 incident PCa cases and 302 controls were included. The selection criteria for both cases and controls were: (i) age between 40-80 years; and (ii) residence in the coverage area of the reference hospitals for 6 months or more prior to recruitment. A score to measure the compliance with the recommendations of 2018 WCRC/AICR criteria was built. The level of compliance was used as a continuous variable and categorized in terciles. The aggressiveness of PCa was determined according to the ISUP classification. Adjusted odds ratios (aOR) and their 95% confidence intervals (95% CI) were estimated using multivariable logistic regression models. A slight protective tendency was observed between the level of compliance with the preventive recommendations and PCa risk, aOR = 0.81 (95% CI 0.69-0.96) for the total cases of PCa. This association also was observed when the aggressiveness was considered. In addition, limiting consumption of "fast foods", sugar-sweetened drinks, and alcohol were independently associated with lower risk of PCa.
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Affiliation(s)
- Olmedo-Requena Rocío
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (L.-L.M.); (S.-B.I.); (S.M.-J.); (J.-M.J.-J.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain
- Correspondence: ; Tel.: +34-958243543
| | - Lozano-Lorca Macarena
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (L.-L.M.); (S.-B.I.); (S.M.-J.); (J.-M.J.-J.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain
| | - Salcedo-Bellido Inmaculada
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (L.-L.M.); (S.-B.I.); (S.M.-J.); (J.-M.J.-J.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain
| | | | | | - García-Caballos Marta
- Cartuja Primary Health Care Centre, Distrito Sanitario Granada-Metropolitano, 18013 Granada, Spain;
| | - Sánchez María-José
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (L.-L.M.); (S.-B.I.); (S.M.-J.); (J.-M.J.-J.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain
- Andalusian School of Public Health (EASP), 18011 Granada, Spain
| | - Jiménez-Moleón José-Juan
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (L.-L.M.); (S.-B.I.); (S.M.-J.); (J.-M.J.-J.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain
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Pérula de Torres LA, Moscosio Cuevas JI, Bartolomé Moreno C, Martín-Carrillo P, Martín-Rabadán M, Jiménez García C. [Knowledge, conduct and attitude before the European Code against Cancer by health professionals of primary care]. Aten Primaria 2020; 52:67-76. [PMID: 30630633 PMCID: PMC7025965 DOI: 10.1016/j.aprim.2018.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 11/05/2018] [Accepted: 11/05/2018] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To decide if Primary Care (PC) professionals know the European Code against Cancer (CECC) and if this relates to practice the recommendations with themselves and with their patients. DESIGN descriptive, observational study. SETTING Spanish Health Centers. PARTICIPANTS Health professionals. INTERVENTIONS self-administered questionnaire. MAIN MEASUREMENTS cancer protective and risk factors, screening for colorectal, breast, cervix and prostate cancer, level of knowledge of the ECAC. RESULTS 1734 participants (10.5%), mean age 47.4 years (SD: 8.6), 71.5% female. 50.0% do not know the CECC; tutors (OR=1.61), assigned to the PAPPS (OR=1.51) and who have been working in AP for more time (OR=2.62) are the ones who know it most. 7.2% smoke and 79.1% drink alcohol. 64.1% presented normal weight and 19% performed physical activity. They avoid exposing themselves to the sun 52.7% and use protectors 53.8%. 85.2% have never had a colorectal screening, 11% never had a cytology, and 12% had a mammogram. There is a relationship between knowing the CECC and smoking (P<.001), overweight/obesity (P=.024), physical activity (P=.003), meat intake (P<.001), mammography (P<.001), cytology (P=.022), PSA (P=.045), as well as the promotion of their advice among patients. CONCLUSIONS The CECC is unknown by half of the AP professionals. The practice of its recommendations is uneven, with the prevalence of low smoking, and sun protection a little extended behavior. Those who know him are the ones who most practice his recommendations.
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Affiliation(s)
- Luis Angel Pérula de Torres
- Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Distrito Sanitario Córdoba y Guadalquivir, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Grupo de Evaluación y mejora del PAPPS (semFYC), Córdoba, España.
| | - Jose Ignacio Moscosio Cuevas
- Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Distrito Sanitario Córdoba y Guadalquivir, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Grupo de Evaluación y mejora del PAPPS (semFYC), Córdoba, España
| | - Cruz Bartolomé Moreno
- Unidad Docente de Medicina Familiar y Comunitaria Sector Zaragoza I, Grupo de Cáncer del PAPPS, Zaragoza, España
| | - Pilar Martín-Carrillo
- Centro de Salud de Yébenes. Grupo de evaluación y mejora del PAPPS (semFYC), Madrid, España
| | - María Martín-Rabadán
- Centro de Salud Can Misses. Grupo de Evaluación y mejora del PAPPS (semFYC), Ibiza, España
| | - Celia Jiménez García
- Distrito Sanitario de Atención Primaria Córdoba y Guadalquivir, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, España
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