Background
The high and increasing global burden of cancer highlights the need for effective implementation of primary cancer prevention programmes targeting modifiable risk factors. However, evidence-based programmes with proven effectiveness in controlled settings often fail when implemented in the real world due to ineffective adaptation and implementation strategies that address context-specific barriers, leading to programme failure and public health inequities. There is a need to provide decision-makers and implementers with tools to effectively adapt and implement evidence-based cancer prevention programmes.
Objectives
The PIECES project aims to adapt and implement existing evidence-based programmes to improve implementation outcomes, thereby increasing the reach and effectiveness of primary prevention programmes in real-world settings. With a consortium of 15 partners, the project team will develop an innovative toolkit that will facilitate the selection, adaptation and implementation of cancer prevention programmes. The toolkit will support implementers with selecting and adapting prevention programmes to improve the fit with the target population and the real-world practice setting.
The main modifiable risk factors that we are aiming to tackle in the project include: tobacco smoking and exposure to second-hand smoke; alcohol consumption; poor physical activity; HPB infection; sun exposure and unhealthy diet.
Impact
The PIECES project has the potential to impact various aspects of scientific, economic, and societal domains:
SCIENTIFIC CONTRIBUTIONS
From a scientific standpoint, the project will likely contribute to the development and consolidation of implementation science in cancer prevention and will provide a new tools that might be further applied in other clinical situations. Besides, the consideration of data science approaches for tool optimization will provide new techniques that may enhance the usability of real-world data in the assessment of effectiveness and selection of optimal strategies and tools for each setting, thus advancing in techniques of implementation science.
ECONOMIC CONTRIBUTIONS
From an economic standpoint, PIECES will likely improve implementation efficiency of primary prevention of cancer programmes. Despite the direct effects on cancer incidence will have a prolonged lag time, improved implementation will ensure a direct impact of PIECES on the effectivity and thus efficiency of investments in primary prevention programmes. In the EU, healthcare spending due to cancer has been estimated to be €57.3 billion in 2017155. We estimate that PIECES can reduce approximately 1% (€0.4 billion) of this expenditure by favouring adaptation and implementation.
SOCIETAL CONTRIBUTIONS
From a societal standpoint, the project is expected to reduce not only cancer-related morbidity and mortality, but also inequities in public health (i.e., the systematic differences between social groups regarding cancer risk and the likelihood of receiving an intervention for the primary prevention of cancer) and productivity (reducing 1% of productivity losses due to morbidity and premature deaths would save €0.4 additional billion). Evidence indicates that most interventions for primary prevention of cancer are more effective among higher socioeconomic groups, thus contributing to growing inequities in cancer.
The PIECES workplan is structured in eight work packages. Learn more ➜