Addressing Differences in Cancer: A Framework for Synergistic Programming in Cancer Prevention and Control

Abstract

Background

Cancer remains a leading cause of death worldwide and disproportionately impacts certain populations. Several frameworks have been developed that illustrate the multiple determinants of cancer. We expand on these frameworks to present an applied framework for cancer prevention and control designed to help better address differences in cancer outcomes.

Methods

The framework was developed by the Cancer Prevention and Control Research Network's Health Behaviors Workgroup. A draft was developed based on workgroup discussion, public health theory, and rapid literature review on the determinants of cancer. The framework was refined through interviews and focus groups with federally qualified health center providers and individuals with cancer, who provided feedback on the framework's causal pathways, completeness, and applicability to cancer.

Results

The framework provides an overview of the relationships between sociodemographic inequalities, social/structural determinants, and risk factors associated with cancer across the lifespan. The framework emphasizes how health-risk behaviors interact with psychological, psychosocial, and biological risk factors. Importantly, the framework emphasizes addressing social and structural determinants that influence health behaviors to reduce the burden of cancer and improve health equity. Our framework underscores the importance of addressing co-occurring risk factors and assessing how multiple forms of inequality or disadvantage intersect to increase cancer risk.

Conclusions

This paper presents an applied framework for cancer prevention and control to address cancer differences. Because the framework highlights determinants and factors that influence cancer risk at multiple levels, it can be used to inform the development, implementation, and evaluation of interventions addressing cancer morbidity and mortality.