Effective primary cancer prevention in occupational health care settings requires strategies tailored to workforce needs and individual risk profiles. Cultural, perceptual, and behavioural factors influence implementation success. Occupational healthcare professionals (OHCPs), with their expertise and regulatory responsibilities, are critical for advancing workplace cancer prevention. This study evaluates the feasibility of primary cancer prevention programs within the Cancer Prevention at Work (CPW) project across Europe from OHCP perspective. CPW is a Horizon Europe funded cross-sectional pilot study (2023–2026) conducted in Italy, Romania, Slovakia, and Spain. It focuses on HCV (Hepatitis C Virus) and Hp (Helicobacter pylori) screening and HPV (Human Papillomavirus) counselling among workers. OHCPs involved in program implementation completed a survey assessing their perceptions of the programs, contextual factors, and their professional role in delivery. Responses were recorded on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree), with higher scores indicating more positive assessments, supportive contexts, and greater OHCP engagement. Data were analysed using descriptive statistics and exploratory analyses. Fifty-five OHCPs completed the survey. Findings suggest that integrating primary cancer prevention into occupational health is feasible. All three programs received positive evaluations (Mean Scores: 4.18–4.23; SD: 0.35–0.38), and organizational conditions, such as resources and leadership support, were rated favorably (Mean Scores: 4.24–4.73; SD: 0.42–0.61). OHCP involvement was moderately high (Mean Scores: 3.69–3.79; SD: 0.34–0.41), indicating meaningful engagement while highlighting opportunities for improvement. Assessments varied by setting and worker group, with more positive evaluations in hospitals and among healthcare or financial workers compared to metal workers. Contextual factors differed across groups, reflecting variability in perceived feasibility and ease of implementation. Conditions for the successful implementation of primary prevention programs targeting HCV, Hp, and HPV related cancers in occupational health services seem present. Particularly, if supported by favourable contextual factors and facilitated by employee participation. These findings offer preliminary evidence for the scalability of workplace-based cancer prevention strategies across diverse European health systems.
BACKGROUND:Most gastric cancer cases are attributable to chronic Helicobacter pylori (H. pylori) infection and can theoretically be prevented. The objectives of the EUROHELICAN project were to assess the feasibility, acceptability, effectiveness, and adverse events of the H. pylori screen-and-treat program in younger adults aged 30 to 34 years, for the first time in Europe; to evaluate long-term effects of H. pylori eradication in middle-aged adults (starting from 45 years of age) previously enrolled for at least 5 years in the GISTAR study in Latvia, and to prepare the IARC expert Working Group Report on population-based H. pylori screen-and-treat strategies for gastric cancer prevention. METHODS:The study of H. pylori screen-and-treat in younger adults was conducted in the Community Healthcare Center Dr. Adolf Drolc Maribor following methodology prepared by the National Institute of Public Health of Slovenia. Assessment of possible effects of H. pylori screen-and-treat in the long term was conducted by following up on the long-running GISTAR study conducted by the Institute of Clinical and Preventive Medicine at the University of Latvia. A team of experts led by the Nantes University Hospital evaluated the study protocols and their progress at different stages. The IARC convened a Working Group of international experts to develop globally applicable guidance on best practices for implementing population-based H. pylori screen-and-treat strategies in adult populations to prevent gastric cancer. CONCLUSIONS:Both studies received a positive evaluation at different stages of completion and were deemed appropriate for testing the feasibility of H. pylori screen-and-treat in a community health care setting and investigating possible adverse effects of the strategy in the long-term. The IARC expert group guidance report on the implementation of population-based H. pylori screen-and-treat strategies to prevent gastric cancer in adults will guide future primary gastric cancer prevention programs in Europe and beyond.
Postoperative pain remains a persistent clinical challenge affecting more than 80% of surgical patients, driving prolonged hospitalization, delayed recovery, and progression to chronic postsurgical pain. Opioid-centered analgesia, despite its historical primacy, is constrained by dependence, tolerance, opioid-induced hyperalgesia, and a critical post-discharge prescribing gap in which prescribed quantities consistently exceed actual patient consumption, perpetuating avoidable harm without proportional improvement in outcomes. Enhanced Recovery After Surgery protocols emphasize multimodal, opioid-sparing strategies combining pharmacologic agents including NSAIDs, acetaminophen, gabapentinoids, ketamine, dexmedetomidine, and intravenous lidocaine with neuraxial and peripheral nerve blocks and non-pharmacologic interventions including cognitive-behavioral therapy, physical rehabilitation, acupuncture, and digital therapeutics. Current evidence identifies NSAIDs combined with dexamethasone or regional anesthesia as delivering the greatest opioid-sparing efficacy, while emerging precision-based approaches incorporating pharmacogenomic-guided prescribing, machine learning-based pain prediction, and wearable monitoring platforms offer transformative opportunities for individualized perioperative analgesic optimization. Significant gaps persist including heterogeneity in multimodal regimen combinations, inconsistent outcome measures, limited post-discharge standardization, and insufficient long-term data on chronic postsurgical pain prevention and functional recovery across diverse surgical populations. Future research must prioritize procedure-specific, standardized, and pharmacogenomically informed multimodal protocols integrating technological innovations to optimize recovery, minimize opioid-related risks, and ensure sustainable, patient-centered perioperative pain management.
Important questions remain regarding differences in geographical and age-specific mortality patterns as the COVID-19 pandemic evolved in consecutive waves, and how COVID-19 mortality compares to seasonal influenza. In a pandemic situation, excess all-cause mortality provides a more complete and robust measure than cause-specific mortality. Data submitted by 26 countries participating in the European Mortality Monitoring (EuroMOMO) network between 2020 and 2023 was analysed to quantify excess all-cause mortality during the COVID-19 pandemic. Excess mortality from this period was compared to previous influenza seasons from 2014 to 2019. Pooled estimates of excess mortality showed four main waves during the COVID-19 pandemic period, most markedly in people aged 65 years and above, with timing and magnitude that varied between countries. Here we show that prior to implementation of control measures and COVID-19 vaccination, excess mortality greatly exceeded typical seasonal influenza mortality, but later during the pandemic was at levels comparable to influenza.
