Background

Cancer prevention is a cornerstone for reducing cancer incidence, improving population health, and ensuring the sustainability of healthcare systems. Despite major advancesin cancer diagnosis and treatment, prevention remainsunderutilised in hospital settings and is frequently addressedas an external public health activity rather than an integralcomponent of oncology. As a result, prevention strategies are often fragmented and insufficiently embedded within routine clinical pathways.

Comprehensive Cancer Centres (CCCs) are uniquelypositioned to integrate evidence-based cancer prevention intoroutine oncology services, reaching not only patients but alsoinformal caregivers and accompanying relatives whofrequently share genetic, behavioural, and environmental riskfactors. Within the European Joint Action EUnetCCC, Task8.2.2 addresses this gap by developing structured Cancer Prevention Hubs as a core pillar of CCC strategy. These hubs aim to operationalise cancer prevention within hospital-basedoncology services, aligned with European quality standards and adaptable to diverse health system contexts.
Objectives
The primary objective was to design and pilot a standardisedyet adaptable Cancer Prevention Hub framework enablingCCCs to implement equitable, evidence-based, and personalised cancer prevention as an integral component of centre-level organisation. The model initially focuses on primary and secondary prevention, with planned future integration of tertiary prevention in collaboration withSurvivorship Hubs. A specific emphasis was placed on informal caregivers and individuals accompanying oncologypatients, a population at increased cancer risk and oftenunderserved by existing prevention programmes.
Methods

Using a co-creation and implementation science approach, CCCs from multiple European countries collaborativelydeveloped a Cancer Prevention Hub framework to support the systematic integration of cancer prevention into routine institutional practice. The development process alignedscientific evidence, clinical feasibility, and organisationalimplementation requirements, with explicit attention to feasibility, scalability, and sustainability across heterogeneoushealthcare settings.?

Results

Participating CCCs co-developed a three-layer Cancer Prevention Hub framework grounded in the European Code Against Cancer, 5th edition (ECAC5). The frameworkcomprises:
(1) Common Ground, to establishing a shared preventionculture by translating evidence-based recommendations intoinstitutional governance structures, policies, and certification requirements;
(2) Cross-Cutting Approach, introducing a risk-factor-basedmodel using short, digital, and literacy-sensitive self-assessment tools addressing major modifiable cancer riskfactors, and automatically linked to tailored educational and brief intervention content; and
(3) Personalised Prevention, delivering targeted preventionpathways for individuals identified as higher risk, includinggenetic counselling, structured lifestyle interventions, and referral to community-based services when appropriate.

As a first operational step, an institutional tobacco riskreduction pathway aligned with ECAC5 recommendationswas developed, to demonstrate the feasibility of translatingevidence-based prevention principles into routine clinicalpractice.?

Conclusions

Cancer Prevention Hubs represent an innovative, hospital-based entry point for integrated and personalised cancer prevention within CCCs. By bridging scientific evidence, organisational commitment, and public health policy, the EUnetCCC framework supports standardisation, accountability, and equitable implementation acrossheterogeneous European health systems. Its multi-level design offers a scalable model for aligning institutional governance, evidence-based prevention, policy relevance, and risk-stratified personalised prevention within routine oncologycare. Added value for implementing centres includesstrengthened governance of prevention, improved monitoring through comparable indicators, and enhanced coordination between oncology services, primary care, and public healthactors, even in settings with limited dedicated prevention infrastructure.