Cancer prevention is often presented as a matter of awareness and access to healthcare services. However, for many people experiencing mental ill-health, prevention can be far more complex — shaped by stigma, fragmented healthcare systems, anxiety, unstable social conditions and difficulties navigating services.
This is the challenge the CO-CAPTAIN project set out to address.
Over the last two years, the project has implemented and tested a Patient Navigation model for cancer prevention in Austria, Greece, Poland and Spain, exploring whether more personalised and coordinated support could help reduce inequalities in access to prevention services among vulnerable populations.
Now, following the conclusion of the pilot phase, the project enters a new stage focused on analysing results, extracting lessons learned and developing future policy recommendations.
From theory to real-life implementation
The pilot programmes were implemented between June 2024 and early 2026 across different healthcare and social care settings.
Rather than applying a rigid intervention, each country adapted the navigation model to its own local context while maintaining the same overall objective: helping participants better access prevention and screening services through continuous and person-centred support.
In practice, this meant creating multidisciplinary networks involving healthcare professionals, social care providers, recruitment centres and trained Patient Navigators.
The scale of implementation varied between countries. Austria reached the highest number of active recruitment centres during the project, with seven centres involved simultaneously, while Spain operated through five centres and Greece and Poland through three each.
At the same time, the number of Patient Navigators progressively expanded throughout implementation, reaching a peak of 13 navigators working across all pilot sites.
What the numbers reveal
Across the four countries, the project approached a total of 1,323 people, ultimately recruiting 320 participants into the pilot programmes.
Participant follow-up remained substantial throughout the intervention. A total of 262 participants completed the first follow-up phase (T1), while 198 participants completed the second follow-up phase (T2).
Recruitment dynamics differed considerably between countries, reflecting both organisational differences and local realities.
Austria approached more than 500 potential participants and recruited 93 people into the programme, while Poland recruited 101 participants from a similarly large outreach effort. Greece recruited 51 participants from 170 approached individuals, whereas Spain achieved particularly high recruitment efficiency, with 75 participants recruited from 78 people approached.
The implementation phase also highlighted one of the key realities of prevention work among vulnerable populations: maintaining engagement over time can be difficult. Drop-out rates varied between countries, illustrating the complexity of long-term interventions involving people who may experience mental health difficulties, unstable life situations or limited trust in healthcare systems.
Yet despite these challenges, all pilot sites succeeded in maintaining active participant engagement and generating valuable implementation experience.
More than information: the role of Patient Navigation
One of the strongest conclusions emerging from the pilots is that prevention cannot rely exclusively on providing information.
For many participants, barriers were emotional and practical as much as medical. Navigating appointments, understanding healthcare systems, managing anxiety or simply feeling confident enough to seek help often became decisive factors.
This is where the Patient Navigation model played a central role.
Patient Navigators worked directly with participants to identify individual prevention needs, facilitate contact with healthcare services, support appointment scheduling and provide continued motivation throughout the process. Their role was not limited to signposting: they helped reduce uncertainty, build confidence and make prevention feel more accessible and manageable.
In several pilot sites, the intervention also contributed to strengthening collaboration between healthcare and social care systems, helping professionals work in a more coordinated and person-centred way.
Different countries, shared challenges
Although the pilots were implemented in different organisational and cultural contexts, many of the challenges identified were remarkably similar across countries.
Across the pilot sites, several shared barriers emerged, including difficulties in accessing prevention services, limited coordination between mental health and physical healthcare, fear or avoidance of healthcare environments, and the lack of tailored support for people experiencing mental ill-health. At the same time, the pilots showed that personalised guidance and continuity of care can help strengthen engagement, trust and participation in prevention pathways.
The experience also reinforced the importance of flexibility. Rather than applying a one-size-fits-all intervention, successful implementation often depended on adapting communication styles, follow-up intensity and support strategies to individual circumstances.
Looking ahead
The conclusion of the pilot phase marks an important transition for CO-CAPTAIN.
Over the coming months, the consortium will continue analysing both quantitative and qualitative findings from the implementation process, including the experiences shared by participants, professionals and Patient Navigators.
These results will contribute to the project’s final recommendations on how Patient Navigation approaches could be integrated into future cancer prevention policies and services across Europe.
More broadly, the pilots have helped demonstrate that reducing inequalities in prevention requires more than expanding services alone. It also requires healthcare systems capable of offering coordinated, accessible and human-centred support to those who need it most.
