Beyond adopting healthy lifestyle habits at an individual level, cancer prevention requires coordinated action through public health policies, primary care services, vaccination programmes and population-based screening programmes.

Primary Prevention

(Reducing exposure to risk factors and promoting health)

1. Tobacco Control

Tobacco control policies are among the most effective measures for reducing the incidence of cancer. These include:

  • Smoke-free public and workplace environments.
  • Restrictions on tobacco advertising and promotion.
  • Increased taxation of tobacco products.
  • Smoking cessation support programmes delivered through primary care services.
  • Regulation of new nicotine products and electronic devices.

These measures aim to reduce both active smoking and involuntary exposure to second-hand smoke.

2. Prevention of Alcohol Consumption

Current public health recommendations emphasise that the risk of cancer increases with any level of alcohol consumption. For this reason, national strategies promote:

  • Reducing or avoiding alcoholic drinks.
  • Limiting the availability and advertising of alcohol.
  • Educational programmes aimed at young people and adults.
  • Brief interventions in primary care to identify risky alcohol consumption.

3. Healthy Diet, Weight Management and Physical Activity

Population-based initiatives include:

  • Promotion of the Mediterranean dietary pattern.
  • Increasing consumption of fruit, vegetables, pulses and wholegrains.
  • Reducing consumption of processed meats, ultra-processed foods and sugary drinks.
  • Promoting regular physical activity at all ages.
  • Creating healthy urban environments that encourage walking, cycling and exercise.

These measures help reduce obesity, a risk factor associated with multiple types of cancer.

4. Protection Against Ultraviolet Radiation

National recommendations include:

  • Avoiding intense sun exposure, particularly between 12 noon and 4 pm.
  • Using appropriate sunscreen, protective clothing and hats.
  • Avoiding sunbeds and artificial tanning devices.
  • Providing targeted education during childhood and adolescence.

5. Prevention of Environmental and Occupational Exposures

Health and occupational authorities implement measures to minimise exposure to carcinogens such as:

  • Asbestos.
  • Radon.
  • Benzene.
  • Crystalline silica.
  • Air pollutants.

These measures include environmental monitoring, workplace safety regulations and occupational risk assessment.

6. Vaccination Programmes

Vaccination is one of the most important preventive measures against certain cancers.

  • HPV vaccination for adolescents of all genders, according to the national vaccination schedule.
  • Hepatitis B vaccination to prevent liver cancer associated with chronic infection.

Vaccination has proven highly effective in reducing infections that can lead to cancer.

7. Health Education

Health promotion campaigns aim to educate the public about:

  • Cancer risk factors.
  • Healthy lifestyle habits.
  • Participation in screening programmes.
  • Recognition of warning signs and symptoms.

Secondary Prevention

Early Detection and Screening Programmes

In Spain, only population-based screening programmes that have demonstrated effectiveness, safety and cost-effectiveness are included in the National Health System's Common Services Portfolio. Currently, three population-based screening programmes are implemented across all autonomous communities.

1. Cervical Cancer Screening

According to the latest Ministry of Health recommendations:

  • Women aged 25 to 29 years: cervical cytology every 3 years for women who have not been adequately vaccinated against HPV.
  • Women aged 30 to 65 years: primary high-risk HPV testing every 5 years.

Organised population screening has progressively replaced the traditional opportunistic screening model.

2. Breast Cancer Screening

  • Aimed at women aged 50 to 69 years.
  • Bilateral mammography every 2 years.
  • Participation in organised screening programmes has been shown to reduce breast cancer mortality.

Breast self-examination does not replace population-based mammography screening.

3. Colorectal Cancer Screening

  • Aimed at men and women aged 50 to 69 years.
  • Faecal immunochemical testing (FIT) every 2 years.
  • Positive results require further investigation with colonoscopy.

In addition to detecting cancer at an early stage, screening can identify and remove precancerous lesions.

4. Other Screening Programmes

At present, population-based screening for lung, prostate, ovarian and skin cancers is not included in the National Health System's routine screening programme portfolio, although some are under scientific evaluation or may be considered for individuals at particularly high risk.

5. Education About Warning Signs and Symptoms

It is important to encourage prompt medical assessment of symptoms such as:

  • Abnormal bleeding.
  • The appearance of lumps or masses.
  • Unintentional weight loss.
  • Persistent changes in bowel or urinary habits.
  • Persistent cough or haemoptysis.
  • Suspicious skin lesions.

Early detection significantly improves outcomes.

Tertiary Prevention

Tertiary prevention aims to reduce the physical, psychological and social consequences of cancer after diagnosis.

1. Timely and Comprehensive Treatment

Ensuring equitable access to:

  • Cancer surgery.
  • Radiotherapy.
  • Chemotherapy.
  • Targeted therapies.
  • Immunotherapy.
  • Biomarker-guided personalised medicine.

2. Cancer Rehabilitation

This includes programmes focused on:

  • Functional recovery.
  • Lymphoedema management.
  • Physical rehabilitation.
  • Nutritional recovery.
  • Psychological support.

3. Palliative Care

Palliative care aims to improve quality of life and symptom control for people with advanced disease and their families.

4. Cancer Survivorship Care

Current National Health System recommendations promote follow-up care for cancer survivors in order to:

  • Detect recurrence.
  • Monitor for second primary cancers.
  • Manage late effects of treatment.

Support social and return-to-work reintegration.