Institutional practices for cancer: Comparison of social and health care along disease trajectory in five countries with high survival rates.
[AIM] This article analyses the institutional practices that shape socio-health care for cancer along the disease trajectory-from screening to survivorship-in five countries with the highest cancer su
APA
Calderón-Figueroa C, Castillo-Delgado A, et al. (2026). Institutional practices for cancer: Comparison of social and health care along disease trajectory in five countries with high survival rates.. Journal of cancer policy, 48, 100733. https://doi.org/10.1016/j.jcpo.2026.100733
MLA
Calderón-Figueroa C, et al.. "Institutional practices for cancer: Comparison of social and health care along disease trajectory in five countries with high survival rates.." Journal of cancer policy, vol. 48, 2026, pp. 100733.
PMID
41871663
Abstract
[AIM] This article analyses the institutional practices that shape socio-health care for cancer along the disease trajectory-from screening to survivorship-in five countries with the highest cancer survival rates: Australia, Belgium, Canada, Costa Rica, and Japan.
[METHODS] Drawing on social practice theory, the study applies a critical documentary analysis of 115 institutional and scientific sources, including national cancer plans, legislation, and clinical guidelines, to examine how material elements, practical knowledge, and shared meanings are articulated in policy and practice.
[RESULTS] Findings reveal consistent patterns across the five high-survival countries, including the strong institutionalisation of screening programmes, continuous strengthening of diagnostic infrastructure, and establishment of interdisciplinary teams. However, significant challenges persist in addressing territorial inequalities, ensuring equitable access, and protecting patients from out-of-pocket costs associated with innovative therapies. Japan is distinguished by its population-based endoscopic screening for gastric cancer, while Australia and Canada lead in culturally adapted, community-based approaches. Costa Rica shows partial implementation through regional pilots, and Belgium displays high diagnostic and therapeutic integration with European networks. Psychosocial, financial, and legal support emerge as indispensable dimensions for achieving equitable and comprehensive cancer care. Non-governmental organisations and community networks play a central role in providing counselling, subsidies, and reintegration support, although their reach varies across contexts. Overall, the study underscores that biomedical innovation alone is insufficient: cancer survival depends on the effective coordination of biomedical, social, cultural, and legal policies within integrated socio-health care systems that prioritise equity and quality of life as key pillars of public cancer policy. In high-performing systems, survivorship is not merely the result of clinical coverage but emerges from an institutional ecosystem that bridges biological recovery and social citizenship.
[METHODS] Drawing on social practice theory, the study applies a critical documentary analysis of 115 institutional and scientific sources, including national cancer plans, legislation, and clinical guidelines, to examine how material elements, practical knowledge, and shared meanings are articulated in policy and practice.
[RESULTS] Findings reveal consistent patterns across the five high-survival countries, including the strong institutionalisation of screening programmes, continuous strengthening of diagnostic infrastructure, and establishment of interdisciplinary teams. However, significant challenges persist in addressing territorial inequalities, ensuring equitable access, and protecting patients from out-of-pocket costs associated with innovative therapies. Japan is distinguished by its population-based endoscopic screening for gastric cancer, while Australia and Canada lead in culturally adapted, community-based approaches. Costa Rica shows partial implementation through regional pilots, and Belgium displays high diagnostic and therapeutic integration with European networks. Psychosocial, financial, and legal support emerge as indispensable dimensions for achieving equitable and comprehensive cancer care. Non-governmental organisations and community networks play a central role in providing counselling, subsidies, and reintegration support, although their reach varies across contexts. Overall, the study underscores that biomedical innovation alone is insufficient: cancer survival depends on the effective coordination of biomedical, social, cultural, and legal policies within integrated socio-health care systems that prioritise equity and quality of life as key pillars of public cancer policy. In high-performing systems, survivorship is not merely the result of clinical coverage but emerges from an institutional ecosystem that bridges biological recovery and social citizenship.