Cancer Prevention Across the Life Course: A Global Public Health and Preventive Oncology Perspective with Focus on LMIC Implementation

Abstract

Sunita Ghike

Background: Cancer is a leading cause of global morbidity and mortality, with a rapidly increasing burden in low- and middle- income countries (LMICs). Although advances in treatment have improved outcomes in many high-income settings, prevention remains inadequately integrated into routine health systems in several regions. A life-course approach—addressing exposures and opportunities for intervention from childhood to older age—offers a coherent framework to reduce incidence, promote earlier detection, and improve equity.

Objective: To synthesize a life-course model for cancer prevention that integrates global public health principles with preventive oncology strategies and highlights practical implementation options for LMICs, including India.

Methods: Narrative review of contemporary evidence and policy guidance on primary prevention (vaccination, risk-factor control), secondary prevention (screening and early diagnosis), and precision prevention (risk stratification and genetic counseling), with emphasis on feasibility and systems design.

Results: Prevention opportunities exist across all life stages, including HPV and hepatitis B vaccination, tobacco and alcohol control, obesity prevention, infection control, occupational and environmental risk reduction, and early detection strategies tailored to local capacity. Genetic testing and counseling can strengthen risk-based prevention but require ethically sound, affordable pathways and trained workforce. LMIC barriers include low awareness, stigma, limited workforce, fragmented referral pathways, weak pathology capacity, and loss to follow-up; practical solutions include integration with primary health care, task-shifting, opportunistic screening platforms, patient navigation, digital tracking tools, and quality-assured partnerships.

Conclusion: A life-course preventive oncology framework grounded in public health principles is scalable and equity-oriented. LMICs can achieve meaningful impact by prioritizing high-value interventions, strengthening referral systems, assuring quality, and incrementally introducing risk-based and genomic approaches.

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