When cancer screening meets research: interviews on engaging European underserved citizens
Abstract
Background: Individuals from lower socioeconomic and/or migrant backgrounds face a higher risk of developing cancer yet remain underrepresented in cancer screening and scientific research. This leads to health inequities and inefficiencies within public health care. In the INSIDERS project we develop and test an inclusive mHealth application to support informed decision-making and engagement in cancer screening and research.
Methods: In the first phase, we explored barriers and facilitators of engagement in cancer screening and related scientific research among underserved populations, focusing on strategies to outreach and support informed decision-making.Interviews with 60 underserved citizens were conducted in the Netherlands, Portugal, and Ireland, transcribed and thematically analysed.
Results: Interviews highlighted that relevance, trust, structural access, and emotional readiness shape decision-making and engagement. Screening and research participation may not always feel personally relevant, with some viewing it as intended for others. Engagement is enabled when invitations are seen as credible and delivered through trusted sources. Regarding combined screening and research, participants highlighted autonomy as essential, emphasising the importance of retaining freedom to accept or decline screening and research separately. Barriers include unclear or missed invitations, administrative steps, difficulty navigating services, and constraints related to time, cost, and competing priorities. Emotional responses, including fear, embarrassment, and uncertainty, affected whether participation feels safe and manageable.
Conclusions: Findings will be used to co-create an mHealth application with underserved citizens, professionals in cancer screening, and scientific researchers. The application aims to improve access to cancer screening, streamline data collection and research recruitment, leading to continuous improvements in public health and public health research.
Key messages: • Engagement in cancer screening and research is shaped not only by knowledge or awareness, but whether screening feels relevant, trusted, feasible, easy to navigate, and supported through attendance.
• Inclusive engagement strategies should combine trusted communication, practical navigation support, and clear separation of screening and research choices to enable voluntary, confident participation.
Related
- Understanding underserved and underrepresented populations in European clinical studies: a narrative review with systematic approach
- Feasibility of screening and brief intervention for multiple health behaviors within a mobile cancer prevention outreach program in underserved areas of Brittany, France
- Engaging children, adolescents and young adults living with rare diseases as research partners: practical considerations for meaningful involvement
- Improving breast and colorectal cancer screening information through co-design with underserved groups in an urban area.
- Effectiveness of health mediation to promote organised cancer screening among underserved and under-screened populations in Marseille, France: findings from a repeated cross-sectional survey.
BibTeX
@article{almeida2026when,
title = {{When cancer screening meets research: interviews on engaging European underserved citizens}},
author = {R Almeida and M Rolink and ND Pallin and F Ventura and MG Diaconu and I Anghelache and P Redmond and M Fransen},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1499},
url = {https://doi.org/10.1093/eurpub/ckag169.1499},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - When cancer screening meets research: interviews on engaging European underserved citizens
AU - R Almeida
AU - M Rolink
AU - ND Pallin
AU - F Ventura
AU - MG Diaconu
AU - I Anghelache
AU - P Redmond
AU - M Fransen
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1499
UR - https://doi.org/10.1093/eurpub/ckag169.1499
AB - Background: Individuals from lower socioeconomic and/or migrant backgrounds face a higher risk of developing cancer yet remain underrepresented in cancer screening and scientific research. This leads to health inequities and inefficiencies within public health care. In the INSIDERS project we develop and test an inclusive mHealth application to support informed decision-making and engagement in cancer screening and research. Methods: In the first phase, we explored barriers and facilitators of engagement in cancer screening and related scientific research among underserved populations, focusing on strategies to outreach and support informed decision-making.Interviews with 60 underserved citizens were conducted in the Netherlands, Portugal, and Ireland, transcribed and thematically analysed. Results: Interviews highlighted that relevance, trust, structural access, and emotional readiness shape decision-making and engagement. Screening and research participation may not always feel personally relevant, with some viewing it as intended for others. Engagement is enabled when invitations are seen as credible and delivered through trusted sources. Regarding combined screening and research, participants highlighted autonomy as essential, emphasising the importance of retaining freedom to accept or decline screening and research separately. Barriers include unclear or missed invitations, administrative steps, difficulty navigating services, and constraints related to time, cost, and competing priorities. Emotional responses, including fear, embarrassment, and uncertainty, affected whether participation feels safe and manageable. Conclusions: Findings will be used to co-create an mHealth application with underserved citizens, professionals in cancer screening, and scientific researchers. The application aims to improve access to cancer screening, streamline data collection and research recruitment, leading to continuous improvements in public health and public health research. Key messages: • Engagement in cancer screening and research is shaped not only by knowledge or awareness, but whether screening feels relevant, trusted, feasible, easy to navigate, and supported through attendance. • Inclusive engagement strategies should combine trusted communication, practical navigation support, and clear separation of screening and research choices to enable voluntary, confident participation.
SN - 1101-1262
SN - 1464-360X
ER -