Enhance primary cancer prevention through sustainable behavioural change

With about 40% of cancer cases being preventable[[Soerjomataram et al. (2018). https://pubmed.ncbi.nlm.nih.gov/30445359/]], prevention represents the most cost-efficient and sustainable cancer control strategy. The Mission on Cancer and Europe’s Beating Cancer Plan aim to exploit the potential of primary cancer prevention by addressing key risk factors and health determinants[[All known risk factors and health determinants, including socio-economic and commercial ones, e.g.: tobacco; alcohol; genetics; bacterial and viral pathogens; chemicals from air, soil, water, and food; physical inactivity; diet and nutrition; gut dysbiosis; behavioural patterns; exposure to ionising radiation, UV, radon; occupational exposure; socio-economic background, education, employment.]].

Achieving sustainable behavioural change can play a major role in enhancing the impact of health promotion and preventive measures and thus contribute to reducing the number of preventable cancer cases. Despite having access to peer-reviewed existing evidence and recommendations[[For example: https://policydatabase.wcrf.org/]] on cancer prevention, widely accepted by policymakers across the EU, their uptake to effectively change behaviour needs to be enhanced.

In the past, evidence on how to achieve behavioural change has not been sufficiently taken into account when designing health promotion and primary prevention programmes. This is because behavioural change is a complex challenge, which is subject to manifold influences that could be better understood at individual and systems level, through public engagement and interdisciplinary approaches.

This requires a systemic approach involving all the main actors at different levels who can facilitate sustainable behavioural change including public authorities, policymakers, health care providers, employers, educational institutions, industry, non-governmental consumer and patient organisations, citizens and media.

Investments are needed to establish, scale-up or improve health promotion and cancer prevention programmes through increased awareness among citizens about cancer risk factors and related behavioural change, with a focus on hard-to-reach and vulnerable groups of the population.

Proposals should further address all of the following:

• Develop, test and evaluate the effective impacts of innovative primary cancer prevention programmes, possibly through the use of novel, including digital, solutions[[Such as e-learning platforms, apps and wearables]], for different population groups which should be involved in the design;
• Provide evidence-based cost-benefit analyses of the proposed programmes;
• Identify and address specific bottlenecks and barriers that prevent the uptake of sustainable behavioural change for different target populations, taking into account sectorial, socio-economic, cultural and geographical[[Across and within countries, covering the urban-rural dimension.]] conditions as well as gender and age;
• Identify the most appropriate actors and develop incentives promoting sustainable behavioural change, such as increasing the uptake of the European Code against Cancer[[European Code Against Cancer - International Agency for Research on Cancer (IARC). European Commission: 12 ways to reduce your cancer risk.]];
• Assess and validate parameters and factors facilitating or impeding behavioural change, and measure their impact;
• In addition, attention should be paid to health determinants, including occupational and environmental factors (e.g. pollution). Furthermore, education, socio-economic status, gender, age, and inequalities to access prevention programmes, which affects for example elderly people, people with disabilities, or minorities and people living in rural areas should be taken into consideration.
• Approaches on how to best reach and involve disadvantaged socio-economic population groups, vulnerable groups, and people living in rural areas, should be developed.

This topic requires the effective contribution of SSH disciplines and the involvement of SSH experts, institutions as well as the inclusion of relevant SSH expertise, in order to produce meaningful and significant effects enhancing the societal impact of the related research activities.

Due consideration should be given to EU-funded initiatives such as: the Climate-neutral and Smart Cities Mission, the Soil Health and Food Mission, as well as the successful proposals resulting from the topics HORIZON-MISS-2022-CANCER-01-01 (Improving and upscaling primary prevention of cancer through implementation research), known by mid-2023, and HORIZON-CL6-2021-FARM2FORK-01-15 (Transition to healthy and sustainable dietary behaviour)[[Proposals FEAST and PLANEAT, see: https://ec.europa.eu/info/funding-tenders/opportunities/portal/screen/opportunities/topic-details/horizon-cl6-2021-farm2fork-01-15]] . Activities should, where appropriate, complement the EU Non-Communicable Diseases Initiative “Healthier together”[[https://health.ec.europa.eu/non-communicable-diseases_en]].

Successful applicants will be asked to liaise with these and other initiatives where applicable[[Applicants are not expected to contact these initiatives before the submission of proposals]]. The successful proposals are expected to liaise with and build on resources made available by the Knowledge Centre on Cancer (KCC) [[Hosted by the European Commission's Joint Research Centre (JRC). Especially through the ’European Guidelines and Quality Assurance Schemes for Breast, Colorectal and Cervical Cancer Screening and Diagnosis‘, and the ’European Cancer Information System (ECIS)’ and the ’European Cancer Inequalities Registry (ECIR), see https://knowledge4policy.ec.europa.eu/cancer_en]] in order to foster EU alignment and coordination.

The Commission will facilitate Mission-specific coordination through future actions, notably fostering exchanges with other proposals funded under this topic. Hence, successful applicants will be asked to join the ‘Prevention’ cluster for the Mission on Cancer, established in 2022[[In order to address the objectives of the Mission on Cancer, participants will collaborate in project clusters to leverage EU-funding, increase networking across sectors and disciplines, and establish a portfolio of Cancer Mission R&I and policy actions.]]. In this regard, the Commission will take on the role of facilitator, including with relevant initiatives and stakeholders, if appropriate.

Therefore, proposals should include a budget for networking, attendance at meetings, and potential joint activities without the prerequisite to give details of these at this stage. Examples of these activities are the organisation of joint workshops, the exchange of knowledge, the establishment of best practices, or the initiation of joint communication activities with projects funded under other clusters and pillars of Horizon Europe, or other EU programmes, as appropriate. The details of joint activities will be defined during the grant agreement preparation phase and during the life of the project.