Participatory Research on Cancer Risk and Public Health in Argentina

Participatory Research on Cancer Risk and Public Health in Argentina | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Participatory Research on Cancer Risk and Public Health in Argentina Francisco Gelman Constantin, Mercedes García Carrillo, María Sofía Amarilla, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8716293/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This study analyzes the results of a survey conducted among students and neighbors from autonomous education institutions in Argentina, focusing on socio-environmental factors influencing cancer risk, to spotlight conditions specific to these communities and produce actionable data. The study consisted of a participatory survey through local autonomous high-schools in four yearly cycles, within three underprivileged neighborhoods around Buenos Aires (Argentina). The survey process was designed and conducted collaboratively between researchers and local actors, using Google Forms. Results were subjected to descriptive statistical analysis. The survey was administered between April 2021 and April 2025 to 173 individuals (124 female and non-binary, 49 male). Results revealed sizeable housing deficits: 33·3% (SE 8·95, p = 0·0196) lacked public sewage access, 19·69% (SE 3·10, p = 0·0252) lacked potable water, and many lived near garbage dumps (26·28%, SE 3·00, p = 0·0011) or flood zones (38·26%, SE 6·37, p = 0·0044), which increased exposure to carcinogens. Socioeconomic conditions contributed to unhealthy lifestyles: 85·61% (SE 0·73, p = 0·0002) reported medium-high stress, 40·8% (SE 6·22, p = 0·1178) lacked physical activity, and diets were poor in fruits/vegetables and proteins (37·19% SE: 9·35, p = 0·1322 and 35·05% SE 6·73, p = 0·04072, respectively), while high in processed foods (85·01% SE 3·64 p = 0·0027) and alcohol (8·28% SE 2·75, p = 0·0003). Only 47·27% (SE 9·38, p = 0·0432) received timely information on early cancer detection. These results highlight structural inequalities in environmental conditions, lifestyle factors, and healthcare access, underscoring the urgent need for targeted health education and systemic interventions. Given the global rise in cancer incidence—particularly in marginalized populations—, this research emphasizes the urgent need to examine how socioeconomic, environmental, and health system factors impact cancer risk in low-income communities. Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Introduction This work brings forth and discusses the results of a participatory research project conducted by a group of teachers, students, and researchers in the framework of four editions (2021, 2022, 2024 and 2025) of a graduate course and an undergraduate Social Educational Practice (PSE, in its Spanish abbreviation) based in the School of Exact and Natural Sciences of a public university in Buenos Aires (Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires), in collaboration with teachers, students and neighbors of three autonomous popular education institutions in underprivileged boroughs of Buenos Aires and its periphery. The project also incorporated members from MACMA, a non-governmental organization (NGO) focused on cancer prevention and patient support, the union of subway workers concerned with the effects of asbestos on their health (AGTSyP), and a grassroots public health organization dealing with the human consequences of pesticide use (Exaltación Salud), located north of the city. It aims to report on the data obtained from surveys conducted among students of the three high schools and people from their local environment, within the framework of workshops, lectures, and other training-participation instances dedicated to the topic of the different pathologies collectively known as cancer, in terms of their biological, social, and environmental dimensions. In 2025, nearly 20 million people were diagnosed with cancer and 10 million people died from this set of diseases worldwide.. Cancer is one of the leading causes of death worldwide, in a ranking headed by cardiovascular diseases, according to data from the World Health Organization. [1] In fact, about one in six people dies from cancer. Argentina is among the countries in the world with medium-high cancer incidence (range 181·1 to 248·3 per 100,000 inhabitants), according to the last reports of the local National Cancer Institute [1] before it was closed. Both global and local numbers are expected to increase, among other things, due to the appearance of new cases generated by the effect of environmental pollutants, increased levels of stress and consumption of tobacco and alcohol, and sedentary lifestyles. [1] Particular attention is due to the global increase in early-onset cancer cases in people under 50, while the need for a change in the initial screening process is still being debated. [1] The marginalization of a large part of the Argentinean population from the right to more effective access to prevention, early detection, and oncological treatment is another important factor contributing to the rise of cancer onset and progression. [2] However, both social and environmental factors in cancer incidence continue to be neglected both in the global and the local research agenda, [3–5] evidence of a scientific dominant discourse and a prevailing research agenda that are better equipped for private profit maximization than for public healthcare purposes. [6] Evidence of the correlation between socioeconomic marginalization and cancer incidence and mortality continues to grow and fully consolidate, accounting for multilayered and interconnected pathways. While a small group of types of cancer (mainly breast, prostate, and colorectal) displays an increased incidence in affluent individuals and socio-geographic areas, the opposite is true for the remaining majority, and mortality is consistently greater in all cancer types for the deprived. [7–10] The most evident contributing factors to the overall higher incidence, as addressed by recent studies, are differences in: a) behavioural patterns like alcohol and tobacco consumption –which together account for 18 to 28% of all occurrences–, diet or physical activity, b) occupation –with the most occupation-related tumors developing amongst manual workers in sectors such as mining and construction; however patterns vary greatly from one country to another as “certain ‘dangerous occupations’ and therefore higher cancer risk [are transferred] to countries with lower resources”–, [10] and c) exposure to environmental pollutants –where “higher exposures to hazardous air pollutants have been observed in areas with greater concentrations of low-income and marginalized communities, including racialized people [...], same-sex male partner households, and isolated immigrants” and likewise “disproportionate exposures among equity-deserving communities have also been observed for non-air-pollutant-related hazards, including water contaminants such as lead, lack of greenspace, and poor walkability scores”–. [11] Most recent evidence compounds these factors through epigenetic pathways, which prolong the aforementioned factors’ consequences intergenerationally. [12] Higher mortality rates for underprivileged people with cancer are linked to obstacles in accessing health care, from screening to treatment. This group generally must travel greater distances to hospitals, pay higher out-of-pocket costs, experience longer referral processes and face communicative barriers, while also displays different attitudes towards the medical setting due to previous experiences and has lower levels of medical literacy. [7,13–18 They also have limited access to the newest screening methods and treatment alternatives. [8,19–20] Comorbidities are also a factor, with statistical analysis showing that they are most harmful in the case of colorectal cancer. [10] Furthermore, comorbidities in general worsen treatment options–. [21] In cancer types such as breast, prostate, and colorectal, which are more prevalent among high-income groups but have a much higher mortality rate among those with the lowest socio-economical status, several causes have been identified, with varying degrees of importance. Firstly, it should be noted that there is a significant level of underreporting amongst low-income, under- or uneducated, racialized, and immigrant populations, with very limited participation in both programmed and spontaneous screening. [18,22–24] Secondly, in the case of breast cancer, remaining incidence discrepancies may be explained by exposure to risk factors in lifestyle, reproductive history, and anthropometric risk factors in the affluent. In contrast, higher mortality in both breast and prostate cancer amongst the disprivileged refers to poor access to and use of screening and other healthcare services, resulting in diagnoses at later stages and less effective therapies, as well as comorbidities. [7,10,25–26] Stage at diagnosis appears to play a lesser role in higher mortality for colorectal cancer, considering later-onset, with worse therapeutic alternatives perhaps carrying the explanatory weight. [8,26] In turn, the recent COVID-19 pandemic, far from affecting all people equally, made the sector with comorbidities such as cancer more likely to become seriously ill. [27–29] To make matters worse, cancer prevention programs, diagnosis, and treatment access were deficient during the isolation period, including early detection and treatment adherence. From the outbreak of the pandemic, warnings were raised that the unprecedented burden of patients with SARS-CoV-2 on healthcare systems worldwide could have major implications for cancer care. Indeed, cancer screening programmes and diagnostic services were reduced in many countries, and patients were more reluctant to seek healthcare services. [30–32] Additionally, the pandemic introduced lifestyle changes that could have a detrimental long-term effect on the health of cancer patients. Delays and interruptions of treatment were notably worse amongst cancer patients from racialized communities and other medically underserved groups. [33,32] Some studies indicate that the backlog of cancer treatment and referrals could take more than ten years to be corrected. [32] The first partial studies in Argentina concerning the effects of the pandemic on the cancer care continuum showed that in the province of Santa Fe there were decreases from 56% to 87% in the number of oncological procedures performed, as well as a 26% reduction in diagnosis. [34] Later studies displayed similar tendencies. For instance, a case study on cervical cancer screening in the province of Jujuy revealed a 72·9% decrease during the first year of the pandemic, accompanied by an 88.9% drop in the total amount of performed colposcopies. [35] Another study focused on colorectal cancer care in an individual hospital in the capital city of Buenos Aires reported a small reduction of surgical procedures but significantly higher mortality rates amongst those patients, moving from 9·75% to 19·6%. It is unclear whether excess mortality corresponded to the relative increase of urgent surgeries over programmed ones, or deficits in the global care continuum. [36] All of these findings suggest the urgency of research into the socioeconomic, health-system, and environmental conditions affecting the risk of cancer in underprivileged communities of middle-low income countries like Argentina, especially in the aftermath of the COVID-19 pandemic. This paper aims at conducting such research in a manner that is at the same time methodologically sound, reflective, community-based, and actionable. Methods Study Area The study is based on three sites: the boroughs of Pompeya, Claypole, and Rincón de Milberg. Pompeya is a 6.2 km 2 neighborhood in the south of the City of Buenos Aires (34°39′00″S 58°25′00″W), over the coast of the highly polluted Riachuelo River. With a population of around 63 thousand people, it belongs to the second poorest district of the city, with an average income 29% below that of the city as a whole. [37] A former industrial region, where factories were surrounded by housing complexes for its workers, it is now a mainly residential borough for underprivileged families, including the 0·7km 2 shanty-town Villa 21-24-NHT Zavaleta. Claypole is a township 26 km to the south of the City of Buenos Aires (34°48′00″S 58°20′00″W), with a population close to 41 thousand inhabitants. It is traversed by several branches of the Sarandí-Santo Domingo basin, a highly polluted water system. Rincón de Milberg is a township 33 km to the north of the City of Buenos Aires (34°24′50″S 58°36′11″W), with a population of around 28.6 thousand people, living in a highly floodable area over the coast of the likewise contaminated Reconquista River. Both Claypole and Rincón de Milberg are mostly low-income boroughs with extreme land development deficits, while they also house highly isolated condominiums. [38–39] Research setting The editions of the PSE “Social Aspects of Cancer” considered in this analysis took place in 2021, 2022, 2024, and 2025, mainly for students of Biology, Chemistry, and Data Science from the University of Buenos Aires, but were also open to students from other disciplines, including participants from the Social Sciences and Humanities. The objective was the acquisition by students of theoretical concepts and skills for the development of integrative and inclusive teaching practices that would address cancer not only in its molecular, cellular, and biomedical dimensions but also in a social and environmental level, as well as to stimulate the social commitment of the students and the articulation with members of vulnerable populations of underprivileged neighborhoods in the Metropolitan Area to the City of Buenos Aires (AMBA). The graduate course “Molecular, Social and Environmental Determinants of Cancer” was offered in 2022, 2024, and 2025 for doctoral students of the School of Exact and Natural Sciences of the same university, while also open to graduate students from other schools and universities. Its general objective was to provide a space for discussion and training in which they could acquire direct practice in the analysis of cancer as a complex disease with an interdisciplinary systems approach. This implied addressing multiple dimensions of the set of pathologies that are called "cancer", ranging from molecular, cellular, and bioinformatics aspects, through biomedical ones, to environmental, cultural, and social dimensions of cancer in the territories. In particular, there was a specific interest in deepening knowledge of the context surrounding these pathologies. This ranged from the democratization of information to enable early detection and improve access to healthcare, to studying the social, environmental, political, and economic determinants that contribute to the increasing frequency of cases worldwide. Thus, within the framework of the PSE and the graduate course, along with the teaching of theoretical contents and the internal debate of the issues in the university classroom, we developed didactic experiences and the work of co-production of knowledge in the popular education institutions of Pompeya (Bachillerato Popular Ezequiel Demonty), Rincón de Milberg (Bachillerato Rincón) and Claypole (Bachillerato Popular Galpón Cultural), together with the union of subway workers fighting the presence of asbestos (AGTSyP) and in consultation with the grassroot health organization dedicated to fighting the use of pesticides (Exaltación Salud). In the case of the work with the popular education spaces that most concerns us here, students of the university offered students of the popular education institutions a series of meetings dedicated to the molecular, social, and environmental aspects of cancer, planned during a series of previous online or face-to-face meetings with teachers of those institutions. And, in a second instance, they collaboratively carried out outreach activities, participatory surveys, and prevention campaigns with them. Outreach activities in the popular education institutions consisted of the interdisciplinary elaboration of materials, graphics, and audiovisuals on cancer, based on its biological, social, and environmental dimensions, and on the care of oncology patients, for members of vulnerable populations in neighborhoods of the AMBA. For this purpose, researchers/professors worked in coordination with MACMA, which provided information on how the foundations that accompany cancer patients and their families work, on palliative care techniques, and on the importance of clinical trials. The campaigns were aimed at cancer prevention and early detection in the same region. They involved the design of a cancer prevention and early detection campaign (including posters, virtual and paper flyers, and audiovisual material, focusing on self-examinations, the PAP test, mammograms, potential carcinogens, prostate-specific antigen or PSA evaluation, etc.). Survey tools Within this framework, self-administered virtual survey cycles were conducted through the Google Forms platform, open to the educational community of the autonomous high schools, and relayed through them to other inhabitants of the three neighborhoods. The surveys collected basic demographic information and addressed questions related to environmental and housing conditions in their area –such as closeness to landfills or connection to sewage–, characteristics of their diet and physical activity, self-reported stress levels, access to information about cancer, factors favoring its occurrence and early detection (including the conditioning factor of internet access), and access to health care, diagnosis and treatment, as well as perception and demand regarding their knowledge over these various facets. Some sections also included open questions to receive feedback, specific demands of knowledge or formative/organizational activities, among others. The sample was extracted from the abovementioned reference population of 132,6 thousand people within the three settings. Quantifiable exploratory results were subject to descriptive statistical analysis and t-tests to assess significance. The survey reached 173 people, out of which 14 answers were excluded from the sample for belonging to participants residing outside of the geographical focus of the study. The remaining 159 results came from adults aged 18 to 58, inhabitants of the three referenced boroughs. Using the Raosoft sample size calculator with an 8% margin of error and a 95% confidence level, the recommended sample size was 150, which makes our end sample rightly suited. [40] Results are expressed as interyearly averages accompanied with their standard errors (SE), except those concerning access to health during the pandemic, which are single-year data. Therefore, while the majority of the data assessed in this paper is of a quantitative nature –since there were few open qualitative questions in the survey– and through a digital platform, the identification of issues, the development of the surveyed variables, the revision of specific questions and the gathering of the sample were a collaborative process of participation that joined university teachers/researchers and students with the entirety of the educational community of the autonomous popular education institutions. Evaluation of results is also embedded in the interpretative framework grown out of the years-long collaboration. This mixed methodology immersed digital quantitative data collection in a participatory process, inspired by prior experiences in the Latin-American tradition of participatory action research (IAP in its original Spanish name [41–44] ). That allowed the generation of numerical information without superimposing that goal to the necessities of the community organizations and their capacity as a collective political subject to appropriate the results and be an active protagonist in the process of knowledge and change. These concerns also align with the aspirations of “citizen science”. [45–46] This was likewise consistent with lessons learned from the experience of participatory research during the pandemic, where an adaptation of face-to-face methods to digital platforms later on made systematic epistemological assessments possible: [43] hybrid processes allowed for the preservation of data quality and impact generation without abandoning technological gains. On the side of the university researchers, teachers, and students, a transdisciplinary approach was fostered, which could both take advantage of the different scholarly trajectories of the participants and be epistemologically open to the composition of different knowledge structures and processes within and beyond the sciences immersed in a democratic interactive experience with different social stakeholders. [43,47–48] Continuous dialogue between parties of all the institutions and organizations permitted an active feedback loop during the whole research trajectory, which perfected the instruments, added variables, and preserved the social relevance of the data. Results In socio-demographic terms, the results showed a greater participation of cis women in the survey process. This group represented 72% of the people surveyed. Beyond this particularity of the respondents, the results illustrated a whole series of dimensions of the living conditions of these populations that have established links with the determination of health, and specifically - in many cases - with an increased risk of developing some form of cancer. In the first place, there is a notorious lack of connection to public sewage systems in 33·3% (SE 8·95) of the people surveyed (Fig. 1 ) , as well as a significant lack of connection to the drinking water network in 19·69% (SE 3·10). Combined with the proximity to garbage dumps (26·28%, SE 3·00) or flood zones (38·26%, SE 6·37), the data indicate structural difficulties to carry out the most basic practices of personal hygiene and cleaning of living spaces recommended by specialists and to avoid or reduce exposure to some pollutants (or, properly speaking, the imposition of them). [49] Levels are also consistently above national averages (Fig. 2 ) . [50] Figure 1 Main housing deficits in the neighborhoods analyzed. Interannual averages in positive and negative answers. (a) Proximity to garbage dumps. (b) Access to running water. (c) Connection to the sewage system. (d) Proximity to flood zones Figure 2 Main housing deficits against national averages . Each point represents one data measurement from each year, n = 3. Statistical significance was determined by t-test, comparing each yearly measurement with its corresponding yearly national average; * p < 0.05. National averages were taken from the National Institute for Statistics and Census (INDEC in int Spanish acronym). (a) Access to running water. (b) Connection to the sewage system. (c) Proximity to garbage dumps. (d) Proximity to flood zones In addition to these socio-environmental determinants, there is a set of effects of socioeconomic conditions on group and individual lifestyles in this population, in terms of stress, the possibility of practicing physical exercise, diet, and potentially harmful consumptions (Figs. 3 and 4 ) . Specifically, 85·61% (SE 0·73) of the people surveyed reported living under medium or high levels of stress, and 40·8% (SE 6·22) did not engage in physical exercise (neither in their free time nor as part of their work, mainly due to lack of time and exhaustion). Figure 3 Effects of socio-economic conditions on lifestyles. Interannual averages of positive and negative answers and reported relative levels. (a) Regular exercise. (b) Reported stress levels Figure 4 Self-reported stress levels . Each point represents one data measurement from each year, n = 3. Statistical significance was determined by t-test; * p < 0.05 In terms of food, the most alarming figure is represented by the low levels of consumption of fruits and vegetables: 37·19% (SE: 9·35) do so less than four times a week, while WHO recommendations are for a daily 400g intake (Fig. 5 ) . [51] If we add to this the fact that only 30·29% (SE 6·91) have full access to organic or agro-ecological varieties, we can see that a very small proportion enjoys the nutritional benefits without the harm of exposure to pesticides. On the other hand, the regular consumption of soft drinks and other industrial beverages (high in sugar or undesirable artificial sweeteners) is ahead of the consumption of juices and natural beverages (63·08% SE 4·37 and 55·51% SE 12·25, respectively) –whereas an individual bottle of the average brands already exceeds the maximum daily advisable intake of free sugars– (Fig. 5 ) . [51] At the same time, given that only 46·64% (SE 12·58) reported frequent consumption of meat or chicken, and 35·05% (SE 6·73) of fish, there are clear doubts about the satisfaction of protein requirements, as well as the recommended intake of fatty acids such as omega-3 and omega-6. [52–53] In contrast, 31·94% (SE 1·13) frequently eat baked goods, pasta, and other products manufactured with wheat flour, and 85·01% (SE 3·64) consume fast food at least once a week, suggesting saturated-fat intakes well above advisable levels. [51] In turn, 44·09% (SE 7·72) smoke tobacco or are passive smokers and 8·28% (SE 2·75) frequently drink alcohol (Figs. 5 and 6 ) . Figure 5 Consumption with positive associations to the incidence of cancer. Interannual averages of reported frequencies outside the recommended levels Figure 6 Animal protein consumption. Interannual averages of reported frequencies compared to minimum requirements for protein intake This set of conditions detrimental to the maintenance of health is reinforced by the difficulties in finding within the health system the different levels of response needed to deal with cancer (Table 1). Barely 47·27% (SE 9·38) of the people surveyed had their needs for information on early detection immediately met by health institutions (a figure that drops to 26·67% during the COVID-19 pandemic). Less than a third had annual early detection cancer-related checkups (28·56% SE 6·37) (Fig. 7), and respondents reported a lack of time for them (54·28% SE 8·57), problems getting appointments (36·82% SE 5·72), and a lack of personal interest (28·01% SE 3·62). With even worse levels during the COVID-19 pandemic, an overwhelming majority encountered difficulties in seeking diagnosis or treatment (53·41% SE 6·34 and 50·1% SE 5·93, respectively, even somewhat above the figures indicated for similar population subgroups by previous studies). [54] In addition to the structural limitations in the health system, there were restrictions in the informal care networks needed to reach the facilities (4·43% SE 2·67), persistent exclusion from their neighborhoods by ambulance services (2·3% SE 1·99), and an alarming number of people who “prefer not to know” about a potential cancer, for fear or other reasons (29·92% SE 6·89). Table 1 Cancer and access to health care. Positive and negative answers’ interannual averages. Questions Yes (%) No (%) Did you receive information about early cancer detection? 47 53 Did you notice any limitations or shortcomings in providing you with early detection information? 53 47 Do you know which are the medical check-ups you can do for early cancer detection? 52 48 Are you in the habit of having annual medical check-ups related to cancer? 29 71 Did you notice any limitations or shortcomings in accessing cancer diagnostics? 53 47 Figure 7 Percentages of the surveyed population undergoing annual cancer-related check-ups or skipping them . Each point represents one data measurement from each year, n = 3. Statistical significance was determined by t-test; * p < 0.05 The 2022 survey on the impact of the COVID-19 pandemic over access to information, diagnosis, and treatment is very informative in identifying crucial issues for future health crises (Table 2). Just as pandemics are mirrors of the societies in which they emerge, the ways in which we respond - or fail to respond - to and during pandemics are strongly suggestive of structural issues. [55–56] Our surveys reveal limitations in the provision of early detection recommendations that could mitigate the effects of a reduced attendance at health centers during social isolation and social distancing (only 27% received such recommendations) and delays in addressing requests for information (only 10% had their demand satisfied). They also show that 43% of the persons surveyed identified obstacles during this socio-sanitary period when it came to accessing diagnosis, and 40% when it came to accessing treatment. Approximately 23% indicated that their own treatment or that of a family member had been interrupted by the pandemic. Table 2 Access to health during the pandemic. Single year percentages. Access to health during the pandemic Yes (%) No (%) Received recommendations about early detection tests 27 73 Experienced delays in the provision of requested early detection information 90 10 Faced institutional obstacles in their path to diagnosis 43 57 Faced institutional obstacles in their path to treatment 40 60 Had their treatment interrupted by the pandemic 23 77 Table 3 Cancer literacy. Positive and negative answers’ interannual averages. Cancer literacy Yes (%) No (%) Knowledge concerning the impact of diet and physical activity on cancer risk 43 57 Knowledge concerning the benefits of fruit and vegetable intake against cancer risk 45 55 Knowledge concerning the benefits of clean water intake against cancer risk 66 34 Knowledge concerning the impact of sweetened drinks on cancer risk 64 36 Knowledge concerning the impact of fast foods on cancer risk 67 33 Knowledge concerning minimal amounts of physical exercise associated with reduced cáncer risk 44 56 Knowledge concerning the benefits of not smoking tobacco against cáncer risk 87 13 Beyond the specifics of that historical context, the obstacles to acquiring information to guide decisions on prevention, diagnosis, or treatment of different forms of cancer are pronounced at numerous levels in a structural capacity. This observation is consistent with and extends the findings of previous studies on the subject. [57–58] The aforementioned drawbacks for users of the health system and some deficiencies in accessing the Internet (expressed by 3·73% SE 1·99 of people) are just two of the factors that explain a strongly unequal distribution of knowledge of critical importance in this area. The lack of knowledge about the general fact that diet and physical activity have an impact on the probability of acquiring some form of cancer, expressed by over half of the people surveyed (56·69% SE 4·23), is similar or even greater with regard to more specific associations, such as the lack of knowledge about the benefits of frequent intake of fruits and vegetables or of drinking clean water (54·77% SE 1·64 and 34·13% SE 11·65 in each case), or about the harm of consuming sweetened drinks (36·53% SE 6·75). Nor does information on the preventive advantages of reducing the consumption of fast food (32·86% SE 8·69 are unaware of them), the minimal amounts of physical exercise that have been shown to be associated with a reduced risk of cancer (only 44·02% SE 8·61 are aware of them) or the beneficial effect of not smoking tobacco (13·88% SE 7·88 are still unaware of them) seem to be sufficiently widespread (Table 3). Equally deficient is access to knowledge about environmental factors that have consequences on cancer incidence, which was reported by only 65·23% SE 3·60 of the respondents. In particular, 38·98% (SE 7·37) did not know what agrotoxics were, despite the fact that over a quarter of those surveyed on this point were aware of being exposed to them (29·05% SE 23·05). The number of people who were unaware of the importance of early cancer detection for better treatment and lower lethality was in turn around 23·95% (SE 5·35). On the other hand, the perception of unmet needs in this area of knowledge also stood out among those surveyed: 94% (SE: 2·52) expressed the urgency for more information on one or several of these dimensions. Discussion The proportion of female survey respondents was well above that of the autonomous popular high schools’ student body. [59] The data shows a greater involvement of women and gender minorities in health issues, which confirms the consolidated findings referred to the majority place of this demographic among those who work both in public and private health systems [60–61] and in social and non-governmental organizations involved in health issues and building care networks. [62] Survey results indicate a significant incidence of several risk factors related both to general health detriment and specifically to cancer. In terms of living conditions, residing in floodable zones and a lack of connection to public sewage systems were the most prevailing factors, while proximity to garbage dumps and a lack of connection to the drinking water network –though less frequent– displayed nonetheless alarming levels. The absence of connection to public networks, the use of well water and septic tanks may involve exposure to several contaminants present in the region's groundwater, [63] with well-established links to an increase in the incidence of different types of cancer. These are the cases of chromium, [64] arsenic, [65–67] nitrates, [68–69] and various pesticides. [70–71] Some studies indicate that proximity to landfills significantly increases the incidence of some forms of cancer, particularly lung cancer, and landfills have been found to emit significant amounts of carcinogenic compounds into the air. [72–74] On the other hand, each of these determinations is in turn an indirect indicator of life under conditions of poverty and social marginalization, which imply a worsening in the probabilities of early detection and survival in relation to several types of cancer, as is the case of breast cancer. [75] As regards life-style risk factors which closely correlate to socio-economic determinations, stress levels, insufficient physical exercise, and dietary imbalances and deficits were also prominent. Both elevated stress levels and exiguous exercise have been linked to a higher incidence of cancer, while improvement in both has shown to better outcomes in diagnosed patients. [76–78] In terms of diet, low levels of consumption of fruits and vegetables (with restricted access to organic or agro-ecological varieties), regular consumption of soft drinks and other industrial beverages, presumably unmet protein and fatty acids requirements, and frequent consumption of manufactured refined wheat-flour products and fast food were most common in our survey. In turn, tobacco and alcohol use remain well above desirable levels. If tobacco consumption is the longest established and most universally recognized carcinogenic determinant, there is already ample evidence of the impact of diet on the deterioration of health and the appearance of different forms of cancer in particular. Such is the case with diets high in fat, refined wheat flour, fried foods and refined sugars, unbalanced in omega-3 and omega-6, low in fiber, or with frequent alcohol intake. [79–83] Inversely, there is a well-proven negative association with abundant intake of vegetables and fruits, and fish. [81–82] The role of meat consumption in the field of prevention and reduction of the lethality of different forms of cancer is complex. On the one hand, red meat continues to be the protein source of choice in Argentine households, [84] so that its consumption levels bear the responsibility of covering the nutritional requirements of that type, necessary for general health maintenance and, specifically, for better prognoses among those undergoing aggressive oncological therapies. [85] On the other hand, red meat consumption has been solidly associated with increased colorectal cancer incidence. [86] Under these conditions, a scientifically based food policy, which in turn specifically addresses the prevention and reduction of cancer lethality, should probably include the guarantee of universal access to the meat consumption necessary to meet protein requirements, and at the same time a food education policy that makes possible their progressive replacement – totally or partially – by other sources of protein that are safer in the long term. Relating our data concerning lifestyle factors to surveyed housing deficits and access to agroecological fruits and vegetables, as well as to registered income levels of the areas, reinforces the need posited by previous scholars to criticize the very notion of “lifestyle” in health studies and health promotion. [87–88] Data on “lifestyle” is too often taken as the basis for recommendations for the individuals that fail to take into consideration structural dimensions strongly conditioning personal choices on diet, and the feasibility of regular exercise or stress-mitigating measures. Our study shows how underprivileged communities have globally deficient diets that far exceed individual choice and require collective solutions. The co-appearance of housing deficits and a lack of regular exercise could suggest that worse local infrastructure for physical activity hinders habits; further local research would be necessary to establish a precise correlation. Respondents also register in full-text sections several socioeconomic sources of stress that are specific to their living conditions. Altogether, sufficient data has been brought forth as to alert for the need to continue monitoring and effect urgent reparation and/or transformative measures on the matter in accordance with previous evidence and parameters. [89–91] Data pertaining to access to health in the cancer-care continuum was likewise concern-provoking. Unmet demands of information regarding early detection, infrequent annual check-ups, and obstacles in the path towards diagnosis and treatment were rampant. That set of difficulties confirms the complex interaction between structural issues and the efforts made against all odds by individuals and their families or affective ecosystems to access care, [92–94] in a scenario in which - as we saw - there is a well-established association between belonging to households with unmet basic needs and the proliferation of various forms of cancer. [95–96] Health access numbers were dramatically worse during the COVID-19 pandemic, which raises alarms in the case of future socio-sanitary crises. Studies developed on a national scale or in other specific regions of the country on the situation of cancer health care during the pandemic [34,97] indicate concurrent results with several of these dimensions: an overall decrease in consultations, diagnoses, treatments, interventions, and hospitalizations; the de-prioritization of non-communicable diseases as a whole; the retraction of cancer screening programs that were already deficient; and a drop in the number of early detection-check-ups (between 56% and 79% depending on the type of cancer), diagnoses (between 84% and 87%) and, to a lesser extent, treatments (3% of people who already had a diagnosis). The scale of our research does not yet allow us to draw conclusions on the quantitative difference between one report and the set of others, but the congruence in the general patterns of decrease strengthens both. The global data suggest a similar trend, although the figures vary from country to country depending on the divergence in pandemic response paradigms and the baseline status of the respective medical systems; in some cases, the impact was offset by the installation of new medical centers and alternative diagnostic and treatment protocols that reduced the potential for transmission, given the increased incidence and lethality of COVID-19 in cancer patients. [30,98–104] During and beyond the pandemic, the detrimental effects of these deficits are compounded by significant gaps in health literacy regarding cancer risk factors of all nature, whereas reported avidity for further education and information on the subject allows for some prudent optimism. Previous research into health and cancer literacy in Argentina through hospital patients or general population had recorded gaps generally consistent with our findings, as well as some indicators of improvement over the last years; [105–108] it has also advised against too strong a reliance on media campaigns, in favor of more community-centered, collaborative approaches. [109–110] The perception of unmet information needs among our surveyed population represents a favourable opportunity for the future advancement of health education and promotion initiatives, encompassing the educational social practices that underpin these surveys, as well as other pertinent types. It is essential to ensure the provision of adequate material resources, organisational support, and institutional commitment to facilitate the active involvement of individuals within their respective communities as participants and co-protagonists in these endeavours. Our results are to be interpreted with caution in reference to the sample size of the survey, imposed by the participatory nature of the research frame, but the final number of respondents remained above the amount suggested by the Raosoft sample size calculator. Furthermore, the output of the exploratory analysis offered in this report is robust in other aspects. Participatory action research produces data that is based on the solid interpersonal trust built along the investigative process amongst all involved actors, in a manner that is unattainable in large-scale surveys, which carries to the reliability of the answers themselves. [41,111] On the other hand, social protagonism during variable determination and data collection ensures usability for grassroots organization and advocacy, which in turn are crucial for the ethical justification of the research process. [112] While the emerging results may display some limitations towards certain precise quantitatively dependent conclusions, they are sufficiently methodologically solid to indicate tendencies, promote further specific research targets and foster multilevel collective processes, as has been reported in similarly devised studies. [40] Furthermore, these data have the potential to serve as a source of inspiration for other communities, universities and researchers, encouraging them to undertake a replication of this investigation with the aim of developing solutions. A separate note is warranted regarding the availability of general data required to generate actionable, country-wide cancer statistics and to guide potential interventions in Argentina. Public records on cancer are historically lacking in terms of subregional disaggregated data, which impairs a specific analysis of how our evidence regarding risk factors impacts incidence and mortality rates. Epidemiological screening on incidence and mortality also lay beyond the scope of our own survey, following the research goals agreed with the local community actors. However, previous local studies have solidly established statistical correlations between our set of detrimental variables in risk patterns and actual incidence and mortality increases, be those the cases of environmental contaminants, [113] ‘lifestyle’ characteristics, [114–115] or health access deficits. [116] Research into the molecular mechanisms, particular immune alterations and the internal exposome of these populations –such as the SPRINT initiative– [117] continue to shed light on the causal pathways behind these correlations. While the State censorship of the results of the SPRINT project occurred in the previous administration, [118] since the national government of Javier Milei sanctioned the dissolution of the National Cancer Institute (INC) information availability will only worsen until tangible preventive health policies are deviced. [119] The destruction and/or defunding of public institutions devoted to health and research can only hinder collective efforts in cancer prevention, early detection and better treatment alternatives, cascading into the concrete experience of communities and patients. Emerging recommendations From the set of quantitative and qualitative knowledge produced throughout this participatory research project, a series of recommendations emerges to be taken into account by the different stakeholders involved in the problems addressed here. All of these recommendations are endorsed not only by the information gathered throughout the execution of the project reported in this paper, but also by the increasingly overwhelming evidence gathered by numerous scientific studies, many of which have been cited throughout, together with precautions established by court rulings. [120] I. Recommendations to the Argentinean public administration in its different jurisdictions To avoid the persistent exposure of people to the set of socio-environmental determinants that have a proven correlation with the increase in the incidence of cancer, several measures need to be taken. Firstly, in order to prevent the imposition to the population of harmful concentrations of chemicals, it is imperative to prohibit the aerial application of agrochemicals at distances of less than 3,000 meters from homes and schools and the terrestrial application at distances of less than 1,095 meters; universal access to drinking water (without significant amounts of carcinogenic compounds) and sewage networks should be likewise guaranteed. The necessary infrastructure works to prevent natural flooding in inhabited areas must be carried out, and the authorizations granted for deforestation and sumptuary building that cause flooding due to human causes must be reevaluated. Local administration also needs to relocate garbage dumps or sanitary landfills to places where they do not affect the living conditions of the communities, and organize a comprehensive waste reduction policy that does not place the responsibility disproportionately on individuals and impoverished communities. Secondly, as regards the consequences of living conditions over “lifestyle” available pathways, governments must guarantee the presence of green spaces suitable for physical exercise in all neighborhoods. They also need to promote, from an economic, educational, and technological standpoint, the development of large-scale agro-ecological agriculture, providing the means to make its products accessible to the entire population. That should fit into a comprehensive food policy that makes it possible to satisfy nutritional needs universally, considering the recommended levels of protein and fatty acid intake, and fruit and vegetable consumption. In terms of the health and education systems, administrations also hold the duty to implement cross-cutting and integrated programs between those systems that make effective access to information on cancer in its socio-environmental, dietary and lifestyle dimensions in general. They must strengthen the public health system in its capacity to provide access to prevention, early detection, diagnosis and treatment of cancer, as well as the social benefits that make possible the continuity of people's attendance to health centers. It is likewise crucial that they should support in institutional, economic and technological matters the work carried out by NGOs and grassroots organizations, and the scientific-technological and university system in terms of community access to information on cancer and its socio-environmental aspects. II. Recommendations to health system workers For the workers who –to high personal costs– hold together the health system through their daily labor, the addressal of some emerging concerns is advisable. It is crucial to identify the obstacles that people encounter within health institutions for the early detection, diagnosis, and treatment of cancer, demanding where appropriate the competent authorities of each jurisdiction regarding the deficits in personnel, infrastructure, and equipment that this requires to be remedied. Local studies so far have identified great regional disparities in access to specialists and diagnostic technologies that have serious impact on delayed diagnosis. [121–123] Our research also signals the relevance of participating in prevention campaigns in collaboration with NGOs, grassroots organizations and/or educational institutions, which address the social need for multidimensional information on cancer. Cross-sector initiatives that foster health promotion and prevention play a crucial role in risk reduction, where media campaigns have shown limitations. They should be regionally and culturally specific, equitable, and allow for social protagonism. III. Recommendations to members of the academic and educational communities Researchers and educators should play a growingly active role in addressing regional specificities for cancer prevention and early detection. It is essential for us to actively participate in cooperation/co-production projects that highlight the local conditions in each territory with respect to the socio-environmental determinants of cancer. Cancer literacy also requires more educational inputs for the general public and for professionals in the various branches concerned that articulate in an integrated manner the various dimensions of cancer. Research agendas and health upper education on cancer have predominantly focused too exclusively on biomedical aspects, neglecting socio-environmental dimensions and multidimensional approaches to prevention. [124] This reflects trends in the hegemonic medical model and the scientific dominant discourse that both lack a holistic approach to health and are highly determined by private-sector profit seek, resulting in the marginalization of the health of underprivileged communities. [3,6,125] These trends urgently need to be counterbalanced in general and in cancer research and education in particular. IV. Recommendations to NGOs and grassroots organizations concerned with health and socio-environmental issues It is advisable for these groups to sustain and strengthen the work carried out jointly with other social and institutional actors in socio-environmental and health education, requiring, when necessary, the collaboration of workers from the health system and the scientific and university systems, and the resources of different types that this demands. NGOs and grassroots organizations have also been key actors in agro-ecological food production and environmental remediation in the last decades. [127–129] Their remarkable work needs to be sustained and strengthened, supported, when necessary, by the collaboration of workers from the agricultural promotion administration and the scientific and university systems, and the resources of different types that this may demand. Only equitable cross-sectorial collaboration and resource allocation can allow for effective implementation. Declarations Ethics declaration This study formed part of the protocol “Assessment of the impact of the COVID-19 pandemic on the diagnosis and treatment of cancer patients” evaluated and approved by the Research Ethics Committee of the Alexander Fleming Institute (IAF), Argentina in accordance with the relevant guidelines and regulations of the Resolution 1480/2011 of the former Argentinian National Ministry of Health and the Declaration of Helsinki. Consent to Participate The participatory survey was designed and conducted collaboratively between researchers and local actors. At the beginning of the online survey, an informed consent text was included, detailing the voluntary acceptance of completing the data, the purpose, anonymity, and data management. Completing the survey implies the participants' consent (Faculty of Social Sciences, University of Buenos Aires). In this regard, informed consent was obtained from all participants. The cycles of self-administered online surveys were conducted on a voluntary and anonymous basis. All data of the participants were kept confidential and used only for research and scientific purposes. Consent to Publish Not applicable. Competing interests The author(s) declare(s) that they have no competing interests. Funding The work was funded by grants for interdisciplinary research and university outreach programs from the Universidad de Buenos Aires (PIUBAS and UBANEX) and the Secretariat of University Policies of the former Argentine Ministry of Education (Voluntariado Universitario and Universidad, Cultura y Territorio). The funding sources had no involvement in study design; collection, analysis, and interpretation of data; in the writing of the report; nor in the decision to submit the paper for publication. Clinical trial number: not applicable. Author Contribution We declare no competing interests. Acknowledgement We would like to express our sincere gratitude to all the students, teachers, and neighbors who participated in this work, as well as to Federico Waisberg (IAF), who collaborated on medical aspects and contributed to the development of the protocol and the evaluation by the ethics committee. Matias Blaustein and Natalia Rubinstein are members of CONICET. Francisco Gelman Constantin was supported by a postdoctoral fellowship from the Agencia I + D + I during the research process. Mercedes García Carrillo was supported by a postdoctoral fellowship from CONICET and by a full-time teaching assistant position from the University of Buenos Aires. María Sofía Amarilla was supported by a doctoral fellowship from CONICET. Data Availability The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. References 1Siegel RL, Kratzer TB, Giaquinto AN, Sung H, Jemal A. Cancer statistics, 2025. CA Cancer J Clin. 2025;75(1):10–45. 10.3322/caac.21871 2Soerjomataram I, Bray F. Planning for tomorrow: global cancer incidence and the role of prevention 2020–2070. Nat Rev Clin Oncol. 2021;18(10):663–72. 10.1038/s41571-021-00514-z 3Testoni FE, García Carrillo M, Gagnon MA, Rikap C, Blaustein M. Whose shoulders is health research standing on? 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Kairos . 7(12):12–32. 109González Arra C, Alvarez Delgado L, Ibañez J, Giai M, Echegaray S, Tomba C, et al. Comunicación de bien público: impacto y recordación de las campañas sobre la prevención del cáncer de mama en Mendoza, Argentina. Investigación Ciencia y Universidad. 2025;9(14):9–17. 10.59872/icu.v9i14.566 . 110Arrighi E, Ruiz de Castilla EM, Peres F et al. Scoping health literacy in Latin America. Glob Health Promot. 2021;29(2):78–87. 10.1177/17579759211016802 111Biehl J, Petryna A. When people come first. Princeton University Press; 2013. 112Fassin D. Truth to be told. Duke University Press; 2017. 113Verzeñassi D, Vallini A, Fernández F, Ferrazini L, Lasagna M, Sosa AJ, Hough GE. Cancer incidence and death rates in Argentine rural towns surrounded by pesticide-treated agricultural land. Clin Epidemiol Glob Health. 2023;20. 10.1016/j.cegh.2023.101239 . 114Pou SA 1, Niclis C, Aballay LR, Tumas N, Román MD, Muñoz SE, Becaria Coquet J, Díaz MP. Cáncer y su asociación con patrones alimentarios en Córdoba (Argentina). Nutr Hosp . 2014;29(3):618–628. 10.3305/NH.2014.29.3.7192 115Coquet B, Caballero J, Camisasso VR, González MC, Niclis MF, Román C, Aballay MD. L. R. Diet Quality, Obesity and Breast Cancer Risk: An Epidemiologic Study in Córdoba, Argentina. Nutr. and Cancer . 2019;72(6), 1026–1035. 10.1080/01635581.2019.1664601 116 da Silva AF, Zanotto BS, Martins F, Navarro N, Alencar R, Medeiros C. Health care accessibility and mobility in breast cancer: a Latin American perspective. BMC Health Serv. Res , 2024;24, 764. 10.1186/s12913-024-11222-6 117Figar S, Ferloni A, Saravi A, Dawidowski AR, Aliperti VI, Bressán I, De Florio F, Vicens J, Braguinsky Golde N, Garcia NK, Pazur G, Hough GE, Gadano AC. Presence of glyphosate in urine due to environmental exposure among populations of agro-industrial areas in Buenos Aires, Argentina. medRxiv . 2024;April 3rd. 10.1101/2024.04.02.24305133 118Miranda DB. Bodies of evidence: poner el cuerpo, activism and scientific practice in a fumigated town [Doctoral dissertation]. University of British Columbia; 2024. 119 De Vito EL. Lecciones tras el cierre del Instituto Nacional del Cáncer: ¿eficiencia o desmantelamiento del sistema de salud? Medicina. 2025;85:634–7. 120Gárgano C. Agroextractivism in Argentina environmental health, scientific agendas, and socioecological crisis. Frontiers in Public Health , 2023; 11, 1304514. 10.3389/fpubh.2023.1304514 121Esteso F, Tissera NS, O'Connor JM, Luca R, Huertas E, Sánchez Loria F, et al. Implementation of a virtual multicenter gastrointestinal tumor board to reduce cancer disparities in Argentina. World J Clin Oncol. 2022;13(6):423–8. 10.5306/wjco.v13.i6.423 . 122Rizzo M, Barros M, Chimondeguy D, Dalurzo ML, Minatta N, Pupareli CS et al. Lung cancer in Argentina. J Thorac Oncol. 2025;20(2):144–9. 10.1016/j.jtho.2024.10.016 123Pascha M, Sun VA, Gilardino L, Legood R. R. Telemammography for breast cancer screening: a cost-effective approach in Argentina. BMJ Health Care Inform. 2021;28(1):e100351. 10.1136/bmjhci-2021-100351 124Martínez Viademonte EA, García Carrillo M, Blaustein M. Argentina: a meta-analysis of the research agenda in cancer and socio-environmental health. SCT Proceedings in Interdisciplinary Insights and Innovations. 2024;2:296. 10.56294/piii2024296 125Blaustein M, Garelli FM. What about health education? Hegemony, paradigms in tension and alternatives. Front Med. 2023;10:1289865. 10.3389/fmed.2023.1289865 126Graziano M, De Groot GS, Pilato LD, Sánchez ML, Izaguirre I, Pizarro HN. Fostering urban transformations in Latin America: lessons around the ecological management of an urban stream in coproduction with a social movement (Buenos Aires, Argentina). Ecol Soc. 2019;24(4):13. 10.5751/ES-11226-240413 . 127Christel LG, Gutiérrez RA. Making Rights Come Alive: Environmental Rights and Modes of Participation in Argentina. J. Environ. Dev . 2017;26(3):322–347. 10.1177/1070496517701248 128Sarandon S, Marasas ME. Brief history of agroecology in Argentina: origins, evolution, and future prospects. Agroecol Sustain Food Syst. 2017;41(3–4):238–55. 10.1080/21683565.2017.1287808 129Gras C, Hernández V. Global agri-food chains in times of COVID-19: the state, agribusiness, and agroecology in Argentina. J Agrar Change. 2021;21(3):629–37. 10.1111/joac.12418 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8716293","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":623444556,"identity":"92c0823e-feca-42f6-84e5-714d5620938a","order_by":0,"name":"Francisco Gelman Constantin","email":"","orcid":"","institution":"University of Buenos Aires","correspondingAuthor":false,"prefix":"","firstName":"Francisco","middleName":"Gelman","lastName":"Constantin","suffix":""},{"id":623444557,"identity":"370f56f8-5c83-4db5-a5d2-54be0f8ffff0","order_by":1,"name":"Mercedes García Carrillo","email":"","orcid":"","institution":"University of Buenos Aires","correspondingAuthor":false,"prefix":"","firstName":"Mercedes","middleName":"García","lastName":"Carrillo","suffix":""},{"id":623444558,"identity":"53c8a625-c7f4-4a2d-8298-94d93f1ebf2c","order_by":2,"name":"María Sofía Amarilla","email":"","orcid":"","institution":"Experimental Medicine and Biology Institute","correspondingAuthor":false,"prefix":"","firstName":"María","middleName":"Sofía","lastName":"Amarilla","suffix":""},{"id":623444559,"identity":"e9a1f9f2-69a9-4787-81b3-5015581919fa","order_by":3,"name":"Natalia Rubinstein","email":"","orcid":"","institution":"University of Buenos Aires","correspondingAuthor":false,"prefix":"","firstName":"Natalia","middleName":"","lastName":"Rubinstein","suffix":""},{"id":623444560,"identity":"7a70dc91-e6bf-44f1-bb18-1e560fd2840b","order_by":4,"name":"Matías Blaustein","email":"data:image/png;base64,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","orcid":"","institution":"University of Buenos Aires","correspondingAuthor":true,"prefix":"","firstName":"Matías","middleName":"","lastName":"Blaustein","suffix":""}],"badges":[],"createdAt":"2026-01-28 04:38:47","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8716293/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8716293/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107097609,"identity":"3809dbcb-d710-4ed6-a5b3-b3cff0807abd","added_by":"auto","created_at":"2026-04-16 17:48:33","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":224875,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eMain housing deficits in the neighborhoods analyzed.\u003c/strong\u003e Interannual averages in positive and negative answers. (a) Proximity to garbage dumps. (b) Access to running water. (c) Connection to the sewage system. (d) Proximity to flood zones\u003c/p\u003e","description":"","filename":"Figures171.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8716293/v1/a8270a887a98203342ff65b1.jpg"},{"id":107481659,"identity":"c856b605-c479-434f-b147-53f5b30d7265","added_by":"auto","created_at":"2026-04-22 02:19:30","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":244434,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eMain housing deficits against national averages\u003c/strong\u003e. Each point represents one data measurement from each year, n = 3. Statistical significance was determined by t-test, comparing each yearly measurement with its corresponding yearly national average; * p \u0026lt; 0.05. National averages were taken from the National Institute for Statistics and Census (INDEC in int Spanish acronym). (a) Access to running water. (b) Connection to the sewage system. (c) Proximity to garbage dumps. (d) Proximity to flood zones\u003c/p\u003e","description":"","filename":"Figures172.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8716293/v1/92c7afed2bfaa4d811ce10e9.jpg"},{"id":107480963,"identity":"b1a75d65-58ee-4c50-b7af-0c7a558e873f","added_by":"auto","created_at":"2026-04-22 02:14:47","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":184887,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eEffects of socio-economic conditions on lifestyles. \u003c/strong\u003eInterannual averages of positive and negative answers and reported relative levels. (a) Regular exercise. (b) Reported stress levels\u003c/p\u003e","description":"","filename":"Figures173.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8716293/v1/7aedbdfd8dcae098768e8a7e.jpg"},{"id":107097612,"identity":"a835d9ba-3e37-44f8-8b59-58187d308882","added_by":"auto","created_at":"2026-04-16 17:48:33","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":176002,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSelf-reported stress levels\u003c/strong\u003e. Each point represents one data measurement from each year, n = 3. Statistical significance was determined by t-test; * p \u0026lt; 0.05\u003c/p\u003e","description":"","filename":"Figures174.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8716293/v1/68f8b60cb8600058ffeea3a6.jpg"},{"id":107480965,"identity":"ee80cc04-747e-4444-b404-6e2cc9872d2d","added_by":"auto","created_at":"2026-04-22 02:14:47","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":220556,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eConsumption with positive associations to the incidence of cancer. \u003c/strong\u003eInterannual averages of reported frequencies outside the recommended levels\u003c/p\u003e","description":"","filename":"Figures175.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8716293/v1/0ac534a27b3c7fc5a0db7917.jpg"},{"id":107097614,"identity":"43390b6a-3a05-4ae9-9419-264a741d59bc","added_by":"auto","created_at":"2026-04-16 17:48:33","extension":"jpg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":180845,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAnimal protein consumption. \u003c/strong\u003eInterannual averages of reported frequencies compared to minimum requirements for protein intake\u003c/p\u003e","description":"","filename":"Figures176.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8716293/v1/9a13b5fb323585d07e966be7.jpg"},{"id":107097615,"identity":"6164f1bb-6c97-4bd8-a126-f6c6afe632f0","added_by":"auto","created_at":"2026-04-16 17:48:33","extension":"jpg","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":175558,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePercentages of the surveyed population undergoing annual cancer-related check-ups or skipping them\u003c/strong\u003e. Each point represents one data measurement from each year, n = 3. Statistical significance was determined by t-test; * p \u0026lt; 0.05\u003c/p\u003e","description":"","filename":"Figures177.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8716293/v1/3b47f6fbc0d75f01b648cbac.jpg"},{"id":107484452,"identity":"0bac2668-37df-4bf3-aa68-57d0a6d8cd5b","added_by":"auto","created_at":"2026-04-22 02:32:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2184826,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8716293/v1/f769746d-d904-403f-9469-9e6e8195d7c3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Participatory Research on Cancer Risk and Public Health in Argentina","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThis work brings forth and discusses the results of a participatory research project conducted by a group of teachers, students, and researchers in the framework of four editions (2021, 2022, 2024 and 2025) of a graduate course and an undergraduate Social Educational Practice (PSE, in its Spanish abbreviation) based in the School of Exact and Natural Sciences of a public university in Buenos Aires (Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires), in collaboration with teachers, students and neighbors of three autonomous popular education institutions in underprivileged boroughs of Buenos Aires and its periphery. The project also incorporated members from MACMA, a non-governmental organization (NGO) focused on cancer prevention and patient support, the union of subway workers concerned with the effects of asbestos on their health (AGTSyP), and a grassroots public health organization dealing with the human consequences of pesticide use (Exaltaci\u0026oacute;n Salud), located north of the city. It aims to report on the data obtained from surveys conducted among students of the three high schools and people from their local environment, within the framework of workshops, lectures, and other training-participation instances dedicated to the topic of the different pathologies collectively known as cancer, in terms of their biological, social, and environmental dimensions.\u003c/p\u003e \u003cp\u003eIn 2025, nearly 20\u0026nbsp;million people were diagnosed with cancer and 10\u0026nbsp;million people died from this set of diseases worldwide.. Cancer is one of the leading causes of death worldwide, in a ranking headed by cardiovascular diseases, according to data from the World Health Organization.\u003csup\u003e[1]\u003c/sup\u003e In fact, about one in six people dies from cancer. Argentina is among the countries in the world with medium-high cancer incidence (range 181\u0026middot;1 to 248\u0026middot;3 per 100,000 inhabitants), according to the last reports of the local National Cancer Institute\u003csup\u003e[1]\u003c/sup\u003e before it was closed. Both global and local numbers are expected to increase, among other things, due to the appearance of new cases generated by the effect of environmental pollutants, increased levels of stress and consumption of tobacco and alcohol, and sedentary lifestyles. \u003csup\u003e[1]\u003c/sup\u003e Particular attention is due to the global increase in early-onset cancer cases in people under 50, while the need for a change in the initial screening process is still being debated.\u003csup\u003e[1]\u003c/sup\u003e The marginalization of a large part of the Argentinean population from the right to more effective access to prevention, early detection, and oncological treatment is another important factor contributing to the rise of cancer onset and progression.\u003csup\u003e[2]\u003c/sup\u003e However, both social and environmental factors in cancer incidence continue to be neglected both in the global and the local research agenda,\u003csup\u003e[3\u0026ndash;5]\u003c/sup\u003e evidence of a scientific dominant discourse and a prevailing research agenda that are better equipped for private profit maximization than for public healthcare purposes.\u003csup\u003e[6]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eEvidence of the correlation between socioeconomic marginalization and cancer incidence and mortality continues to grow and fully consolidate, accounting for multilayered and interconnected pathways. While a small group of types of cancer (mainly breast, prostate, and colorectal) displays an increased incidence in affluent individuals and socio-geographic areas, the opposite is true for the remaining majority, and mortality is consistently greater in all cancer types for the deprived.\u003csup\u003e[7\u0026ndash;10]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe most evident contributing factors to the overall higher incidence, as addressed by recent studies, are differences in: a) behavioural patterns like alcohol and tobacco consumption \u0026ndash;which together account for 18 to 28% of all occurrences\u0026ndash;, diet or physical activity, b) occupation \u0026ndash;with the most occupation-related tumors developing amongst manual workers in sectors such as mining and construction; however patterns vary greatly from one country to another as \u0026ldquo;certain \u0026lsquo;dangerous occupations\u0026rsquo; and therefore higher cancer risk [are transferred] to countries with lower resources\u0026rdquo;\u0026ndash;,\u003csup\u003e[10]\u003c/sup\u003e and c) exposure to environmental pollutants \u0026ndash;where \u0026ldquo;higher exposures to hazardous air pollutants have been observed in areas with greater concentrations of low-income and marginalized communities, including racialized people [...], same-sex male partner households, and isolated immigrants\u0026rdquo; and likewise \u0026ldquo;disproportionate exposures among equity-deserving communities have also been observed for non-air-pollutant-related hazards, including water contaminants such as lead, lack of greenspace, and poor walkability scores\u0026rdquo;\u0026ndash;.\u003csup\u003e[11]\u003c/sup\u003e Most recent evidence compounds these factors through epigenetic pathways, which prolong the aforementioned factors\u0026rsquo; consequences intergenerationally.\u003csup\u003e[12]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eHigher mortality rates for underprivileged people with cancer are linked to obstacles in accessing health care, from screening to treatment. This group generally must travel greater distances to hospitals, pay higher out-of-pocket costs, experience longer referral processes and face communicative barriers, while also displays different attitudes towards the medical setting due to previous experiences and has lower levels of medical literacy.\u003csup\u003e[7,13\u0026ndash;18\u003c/sup\u003e They also have limited access to the newest screening methods and treatment alternatives.\u003csup\u003e[8,19\u0026ndash;20]\u003c/sup\u003e Comorbidities are also a factor, with statistical analysis showing that they are most harmful in the case of colorectal cancer.\u003csup\u003e[10]\u003c/sup\u003e Furthermore, comorbidities in general worsen treatment options\u0026ndash;.\u003csup\u003e[21]\u003c/sup\u003e In cancer types such as breast, prostate, and colorectal, which are more prevalent among high-income groups but have a much higher mortality rate among those with the lowest socio-economical status, several causes have been identified, with varying degrees of importance. Firstly, it should be noted that there is a significant level of underreporting amongst low-income, under- or uneducated, racialized, and immigrant populations, with very limited participation in both programmed and spontaneous screening.\u003csup\u003e[18,22\u0026ndash;24]\u003c/sup\u003e Secondly, in the case of breast cancer, remaining incidence discrepancies may be explained by exposure to risk factors in lifestyle, reproductive history, and anthropometric risk factors in the affluent. In contrast, higher mortality in both breast and prostate cancer amongst the disprivileged refers to poor access to and use of screening and other healthcare services, resulting in diagnoses at later stages and less effective therapies, as well as comorbidities.\u003csup\u003e[7,10,25\u0026ndash;26]\u003c/sup\u003e Stage at diagnosis appears to play a lesser role in higher mortality for colorectal cancer, considering later-onset, with worse therapeutic alternatives perhaps carrying the explanatory weight.\u003csup\u003e[8,26]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn turn, the recent COVID-19 pandemic, far from affecting all people equally, made the sector with comorbidities such as cancer more likely to become seriously ill.\u003csup\u003e[27\u0026ndash;29]\u003c/sup\u003e To make matters worse, cancer prevention programs, diagnosis, and treatment access were deficient during the isolation period, including early detection and treatment adherence. From the outbreak of the pandemic, warnings were raised that the unprecedented burden of patients with SARS-CoV-2 on healthcare systems worldwide could have major implications for cancer care. Indeed, cancer screening programmes and diagnostic services were reduced in many countries, and patients were more reluctant to seek healthcare services.\u003csup\u003e[30\u0026ndash;32]\u003c/sup\u003e Additionally, the pandemic introduced lifestyle changes that could have a detrimental long-term effect on the health of cancer patients. Delays and interruptions of treatment were notably worse amongst cancer patients from racialized communities and other medically underserved groups.\u003csup\u003e[33,32]\u003c/sup\u003e Some studies indicate that the backlog of cancer treatment and referrals could take more than ten years to be corrected.\u003csup\u003e[32]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe first partial studies in Argentina concerning the effects of the pandemic on the cancer care continuum showed that in the province of Santa Fe there were decreases from 56% to 87% in the number of oncological procedures performed, as well as a 26% reduction in diagnosis.\u003csup\u003e[34]\u003c/sup\u003e Later studies displayed similar tendencies. For instance, a case study on cervical cancer screening in the province of Jujuy revealed a 72\u0026middot;9% decrease during the first year of the pandemic, accompanied by an 88.9% drop in the total amount of performed colposcopies.\u003csup\u003e[35]\u003c/sup\u003e Another study focused on colorectal cancer care in an individual hospital in the capital city of Buenos Aires reported a small reduction of surgical procedures but significantly higher mortality rates amongst those patients, moving from 9\u0026middot;75% to 19\u0026middot;6%. It is unclear whether excess mortality corresponded to the relative increase of urgent surgeries over programmed ones, or deficits in the global care continuum.\u003csup\u003e[36]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAll of these findings suggest the urgency of research into the socioeconomic, health-system, and environmental conditions affecting the risk of cancer in underprivileged communities of middle-low income countries like Argentina, especially in the aftermath of the COVID-19 pandemic. This paper aims at conducting such research in a manner that is at the same time methodologically sound, reflective, community-based, and actionable.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy Area\u003c/p\u003e \u003cp\u003eThe study is based on three sites: the boroughs of Pompeya, Claypole, and Rinc\u0026oacute;n de Milberg. Pompeya is a 6.2 km\u003csup\u003e2\u003c/sup\u003e neighborhood in the south of the City of Buenos Aires (34\u0026deg;39\u0026prime;00\u0026Prime;S 58\u0026deg;25\u0026prime;00\u0026Prime;W), over the coast of the highly polluted Riachuelo River. With a population of around 63 thousand people, it belongs to the second poorest district of the city, with an average income 29% below that of the city as a whole.\u003csup\u003e[37]\u003c/sup\u003e A former industrial region, where factories were surrounded by housing complexes for its workers, it is now a mainly residential borough for underprivileged families, including the 0\u0026middot;7km\u003csup\u003e2\u003c/sup\u003e shanty-town Villa 21-24-NHT Zavaleta. Claypole is a township 26 km to the south of the City of Buenos Aires (34\u0026deg;48\u0026prime;00\u0026Prime;S 58\u0026deg;20\u0026prime;00\u0026Prime;W), with a population close to 41 thousand inhabitants. It is traversed by several branches of the Sarand\u0026iacute;-Santo Domingo basin, a highly polluted water system. Rinc\u0026oacute;n de Milberg is a township 33 km to the north of the City of Buenos Aires (34\u0026deg;24\u0026prime;50\u0026Prime;S 58\u0026deg;36\u0026prime;11\u0026Prime;W), with a population of around 28.6 thousand people, living in a highly floodable area over the coast of the likewise contaminated Reconquista River. Both Claypole and Rinc\u0026oacute;n de Milberg are mostly low-income boroughs with extreme land development deficits, while they also house highly isolated condominiums.\u003csup\u003e[38\u0026ndash;39]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eResearch setting\u003c/p\u003e \u003cp\u003eThe editions of the PSE \u0026ldquo;Social Aspects of Cancer\u0026rdquo; considered in this analysis took place in 2021, 2022, 2024, and 2025, mainly for students of Biology, Chemistry, and Data Science from the University of Buenos Aires, but were also open to students from other disciplines, including participants from the Social Sciences and Humanities. The objective was the acquisition by students of theoretical concepts and skills for the development of integrative and inclusive teaching practices that would address cancer not only in its molecular, cellular, and biomedical dimensions but also in a social and environmental level, as well as to stimulate the social commitment of the students and the articulation with members of vulnerable populations of underprivileged neighborhoods in the Metropolitan Area to the City of Buenos Aires (AMBA).\u003c/p\u003e \u003cp\u003eThe graduate course \u0026ldquo;Molecular, Social and Environmental Determinants of Cancer\u0026rdquo; was offered in 2022, 2024, and 2025 for doctoral students of the School of Exact and Natural Sciences of the same university, while also open to graduate students from other schools and universities. Its general objective was to provide a space for discussion and training in which they could acquire direct practice in the analysis of cancer as a complex disease with an interdisciplinary systems approach. This implied addressing multiple dimensions of the set of pathologies that are called \"cancer\", ranging from molecular, cellular, and bioinformatics aspects, through biomedical ones, to environmental, cultural, and social dimensions of cancer in the territories. In particular, there was a specific interest in deepening knowledge of the context surrounding these pathologies. This ranged from the democratization of information to enable early detection and improve access to healthcare, to studying the social, environmental, political, and economic determinants that contribute to the increasing frequency of cases worldwide.\u003c/p\u003e \u003cp\u003eThus, within the framework of the PSE and the graduate course, along with the teaching of theoretical contents and the internal debate of the issues in the university classroom, we developed didactic experiences and the work of co-production of knowledge in the popular education institutions of Pompeya (Bachillerato Popular Ezequiel Demonty), Rinc\u0026oacute;n de Milberg (Bachillerato Rinc\u0026oacute;n) and Claypole (Bachillerato Popular Galp\u0026oacute;n Cultural), together with the union of subway workers fighting the presence of asbestos (AGTSyP) and in consultation with the grassroot health organization dedicated to fighting the use of pesticides (Exaltaci\u0026oacute;n Salud). In the case of the work with the popular education spaces that most concerns us here, students of the university offered students of the popular education institutions a series of meetings dedicated to the molecular, social, and environmental aspects of cancer, planned during a series of previous online or face-to-face meetings with teachers of those institutions. And, in a second instance, they collaboratively carried out outreach activities, participatory surveys, and prevention campaigns with them.\u003c/p\u003e \u003cp\u003eOutreach activities in the popular education institutions consisted of the interdisciplinary elaboration of materials, graphics, and audiovisuals on cancer, based on its biological, social, and environmental dimensions, and on the care of oncology patients, for members of vulnerable populations in neighborhoods of the AMBA. For this purpose, researchers/professors worked in coordination with MACMA, which provided information on how the foundations that accompany cancer patients and their families work, on palliative care techniques, and on the importance of clinical trials. The campaigns were aimed at cancer prevention and early detection in the same region. They involved the design of a cancer prevention and early detection campaign (including posters, virtual and paper flyers, and audiovisual material, focusing on self-examinations, the PAP test, mammograms, potential carcinogens, prostate-specific antigen or PSA evaluation, etc.).\u003c/p\u003e \u003cp\u003eSurvey tools\u003c/p\u003e \u003cp\u003eWithin this framework, self-administered virtual survey cycles were conducted through the Google Forms platform, open to the educational community of the autonomous high schools, and relayed through them to other inhabitants of the three neighborhoods. The surveys collected basic demographic information and addressed questions related to environmental and housing conditions in their area \u0026ndash;such as closeness to landfills or connection to sewage\u0026ndash;, characteristics of their diet and physical activity, self-reported stress levels, access to information about cancer, factors favoring its occurrence and early detection (including the conditioning factor of internet access), and access to health care, diagnosis and treatment, as well as perception and demand regarding their knowledge over these various facets. Some sections also included open questions to receive feedback, specific demands of knowledge or formative/organizational activities, among others. The sample was extracted from the abovementioned reference population of 132,6 thousand people within the three settings. Quantifiable exploratory results were subject to descriptive statistical analysis and t-tests to assess significance. The survey reached 173 people, out of which 14 answers were excluded from the sample for belonging to participants residing outside of the geographical focus of the study. The remaining 159 results came from adults aged 18 to 58, inhabitants of the three referenced boroughs. Using the Raosoft sample size calculator with an 8% margin of error and a 95% confidence level, the recommended sample size was 150, which makes our end sample rightly suited.\u003csup\u003e[40]\u003c/sup\u003e Results are expressed as interyearly averages accompanied with their standard errors (SE), except those concerning access to health during the pandemic, which are single-year data.\u003c/p\u003e \u003cp\u003eTherefore, while the majority of the data assessed in this paper is of a quantitative nature \u0026ndash;since there were few open qualitative questions in the survey\u0026ndash; and through a digital platform, the identification of issues, the development of the surveyed variables, the revision of specific questions and the gathering of the sample were a collaborative process of participation that joined university teachers/researchers and students with the entirety of the educational community of the autonomous popular education institutions. Evaluation of results is also embedded in the interpretative framework grown out of the years-long collaboration. This mixed methodology immersed digital quantitative data collection in a participatory process, inspired by prior experiences in the Latin-American tradition of participatory action research (IAP in its original Spanish name\u003csup\u003e[41\u0026ndash;44]\u003c/sup\u003e). That allowed the generation of numerical information without superimposing that goal to the necessities of the community organizations and their capacity as a collective political subject to appropriate the results and be an active protagonist in the process of knowledge and change. These concerns also align with the aspirations of \u0026ldquo;citizen science\u0026rdquo;.\u003csup\u003e[45\u0026ndash;46]\u003c/sup\u003e This was likewise consistent with lessons learned from the experience of participatory research during the pandemic, where an adaptation of face-to-face methods to digital platforms later on made systematic epistemological assessments possible:\u003csup\u003e[43]\u003c/sup\u003e hybrid processes allowed for the preservation of data quality and impact generation without abandoning technological gains. On the side of the university researchers, teachers, and students, a transdisciplinary approach was fostered, which could both take advantage of the different scholarly trajectories of the participants and be epistemologically open to the composition of different knowledge structures and processes within and beyond the sciences immersed in a democratic interactive experience with different social stakeholders.\u003csup\u003e[43,47\u0026ndash;48]\u003c/sup\u003e Continuous dialogue between parties of all the institutions and organizations permitted an active feedback loop during the whole research trajectory, which perfected the instruments, added variables, and preserved the social relevance of the data.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn socio-demographic terms, the results showed a greater participation of cis women in the survey process. This group represented 72% of the people surveyed. Beyond this particularity of the respondents, the results illustrated a whole series of dimensions of the living conditions of these populations that have established links with the determination of health, and specifically - in many cases - with an increased risk of developing some form of cancer.\u003c/p\u003e\n\u003cp\u003eIn the first place, there is a notorious lack of connection to public sewage systems in 33\u0026middot;3% (SE 8\u0026middot;95) of the people surveyed (Fig.\u0026nbsp;1\u003cstrong\u003e)\u003c/strong\u003e, as well as a significant lack of connection to the drinking water network in 19\u0026middot;69% (SE 3\u0026middot;10). Combined with the proximity to garbage dumps (26\u0026middot;28%, SE 3\u0026middot;00) or flood zones (38\u0026middot;26%, SE 6\u0026middot;37), the data indicate structural difficulties to carry out the most basic practices of personal hygiene and cleaning of living spaces recommended by specialists and to avoid or reduce exposure to some pollutants (or, properly speaking, the imposition of them).\u003csup\u003e[49]\u003c/sup\u003e Levels are also consistently above national averages (Fig.\u0026nbsp;2\u003cstrong\u003e)\u003c/strong\u003e.\u003csup\u003e[50]\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFigure\u0026nbsp;1 Main housing deficits in the neighborhoods analyzed.\u003c/strong\u003e Interannual averages in positive and negative answers. (a) Proximity to garbage dumps. (b) Access to running water. (c) Connection to the sewage system. (d) Proximity to flood zones\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFigure\u0026nbsp;2 Main housing deficits against national averages\u003c/strong\u003e. Each point represents one data measurement from each year, n\u0026thinsp;=\u0026thinsp;3. Statistical significance was determined by t-test, comparing each yearly measurement with its corresponding yearly national average; * p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. National averages were taken from the National Institute for Statistics and Census (INDEC in int Spanish acronym). (a) Access to running water. (b) Connection to the sewage system. (c) Proximity to garbage dumps. (d) Proximity to flood zones\u003c/p\u003e\n\u003cp\u003eIn addition to these socio-environmental determinants, there is a set of effects of socioeconomic conditions on group and individual lifestyles in this population, in terms of stress, the possibility of practicing physical exercise, diet, and potentially harmful consumptions (Figs.\u0026nbsp;3 and 4\u003cstrong\u003e)\u003c/strong\u003e. Specifically, 85\u0026middot;61% (SE 0\u0026middot;73) of the people surveyed reported living under medium or high levels of stress, and 40\u0026middot;8% (SE 6\u0026middot;22) did not engage in physical exercise (neither in their free time nor as part of their work, mainly due to lack of time and exhaustion).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFigure\u0026nbsp;3 Effects of socio-economic conditions on lifestyles.\u003c/strong\u003e Interannual averages of positive and negative answers and reported relative levels. (a) Regular exercise. (b) Reported stress levels\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFigure\u0026nbsp;4 Self-reported stress levels\u003c/strong\u003e. Each point represents one data measurement from each year, n\u0026thinsp;=\u0026thinsp;3. Statistical significance was determined by t-test; * p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\n\u003cp\u003eIn terms of food, the most alarming figure is represented by the low levels of consumption of fruits and vegetables: 37\u0026middot;19% (SE: 9\u0026middot;35) do so less than four times a week, while WHO recommendations are for a daily 400g intake (Fig.\u0026nbsp;5\u003cstrong\u003e)\u003c/strong\u003e.\u003csup\u003e[51]\u003c/sup\u003e If we add to this the fact that only 30\u0026middot;29% (SE 6\u0026middot;91) have full access to organic or agro-ecological varieties, we can see that a very small proportion enjoys the nutritional benefits without the harm of exposure to pesticides. On the other hand, the regular consumption of soft drinks and other industrial beverages (high in sugar or undesirable artificial sweeteners) is ahead of the consumption of juices and natural beverages (63\u0026middot;08% SE 4\u0026middot;37 and 55\u0026middot;51% SE 12\u0026middot;25, respectively) \u0026ndash;whereas an individual bottle of the average brands already exceeds the maximum daily advisable intake of free sugars\u0026ndash; (Fig.\u0026nbsp;5\u003cstrong\u003e)\u003c/strong\u003e.\u003csup\u003e[51]\u003c/sup\u003e At the same time, given that only 46\u0026middot;64% (SE 12\u0026middot;58) reported frequent consumption of meat or chicken, and 35\u0026middot;05% (SE 6\u0026middot;73) of fish, there are clear doubts about the satisfaction of protein requirements, as well as the recommended intake of fatty acids such as omega-3 and omega-6.\u003csup\u003e[52\u0026ndash;53]\u003c/sup\u003e In contrast, 31\u0026middot;94% (SE 1\u0026middot;13) frequently eat baked goods, pasta, and other products manufactured with wheat flour, and 85\u0026middot;01% (SE 3\u0026middot;64) consume fast food at least once a week, suggesting saturated-fat intakes well above advisable levels.\u003csup\u003e[51]\u003c/sup\u003e In turn, 44\u0026middot;09% (SE 7\u0026middot;72) smoke tobacco or are passive smokers and 8\u0026middot;28% (SE 2\u0026middot;75) frequently drink alcohol (Figs.\u0026nbsp;5 and 6\u003cstrong\u003e)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFigure\u0026nbsp;5 Consumption with positive associations to the incidence of cancer.\u003c/strong\u003e Interannual averages of reported frequencies outside the recommended levels\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFigure\u0026nbsp;6 Animal protein consumption.\u003c/strong\u003e Interannual averages of reported frequencies compared to minimum requirements for protein intake\u003c/p\u003e\n\u003cp\u003eThis set of conditions detrimental to the maintenance of health is reinforced by the difficulties in finding within the health system the different levels of response needed to deal with cancer (Table 1). Barely 47\u0026middot;27% (SE 9\u0026middot;38) of the people surveyed had their needs for information on early detection immediately met by health institutions (a figure that drops to 26\u0026middot;67% during the COVID-19 pandemic). Less than a third had annual early detection cancer-related checkups (28\u0026middot;56% SE 6\u0026middot;37) (Fig.\u0026nbsp;7), and respondents reported a lack of time for them (54\u0026middot;28% SE 8\u0026middot;57), problems getting appointments (36\u0026middot;82% SE 5\u0026middot;72), and a lack of personal interest (28\u0026middot;01% SE 3\u0026middot;62). With even worse levels during the COVID-19 pandemic, an overwhelming majority encountered difficulties in seeking diagnosis or treatment (53\u0026middot;41% SE 6\u0026middot;34 and 50\u0026middot;1% SE 5\u0026middot;93, respectively, even somewhat above the figures indicated for similar population subgroups by previous studies).\u003csup\u003e[54]\u003c/sup\u003e In addition to the structural limitations in the health system, there were restrictions in the informal care networks needed to reach the facilities (4\u0026middot;43% SE 2\u0026middot;67), persistent exclusion from their neighborhoods by ambulance services (2\u0026middot;3% SE 1\u0026middot;99), and an alarming number of people who \u0026ldquo;prefer not to know\u0026rdquo; about a potential cancer, for fear or other reasons (29\u0026middot;92% SE 6\u0026middot;89).\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 1\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003e\u003cstrong\u003eCancer and access to health care.\u003c/strong\u003e Positive and negative answers\u0026rsquo; interannual averages.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eQuestions\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eYes (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003eNo (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eDid you receive information about early cancer detection?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eDid you notice any limitations or shortcomings in providing you with early detection information?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eDo you know which are the medical check-ups you can do for early cancer detection?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eAre you in the habit of having annual medical check-ups related to cancer?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eDid you notice any limitations or shortcomings in accessing cancer diagnostics?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eFigure\u0026nbsp;7 Percentages of the surveyed population undergoing annual cancer-related check-ups or skipping them\u003c/strong\u003e. Each point represents one data measurement from each year, n\u0026thinsp;=\u0026thinsp;3. Statistical significance was determined by t-test; * p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\n\u003cp\u003eThe 2022 survey on the impact of the COVID-19 pandemic over access to information, diagnosis, and treatment is very informative in identifying crucial issues for future health crises (Table 2). Just as pandemics are mirrors of the societies in which they emerge, the ways in which we respond - or fail to respond - to and during pandemics are strongly suggestive of structural issues.\u003csup\u003e[55\u0026ndash;56]\u003c/sup\u003e Our surveys reveal limitations in the provision of early detection recommendations that could mitigate the effects of a reduced attendance at health centers during social isolation and social distancing (only 27% received such recommendations) and delays in addressing requests for information (only 10% had their demand satisfied). They also show that 43% of the persons surveyed identified obstacles during this socio-sanitary period when it came to accessing diagnosis, and 40% when it came to accessing treatment. Approximately 23% indicated that their own treatment or that of a family member had been interrupted by the pandemic.\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 2\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003e\u003cstrong\u003eAccess to health during the pandemic.\u003c/strong\u003e Single year percentages.\u0026nbsp;\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eAccess to health during the pandemic\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eYes (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003eNo (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eReceived recommendations about early detection tests\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eExperienced delays in the provision of requested early detection information\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eFaced institutional obstacles in their path to diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eFaced institutional obstacles in their path to treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eHad their treatment interrupted by the pandemic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv\u003e\n \u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 3\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003e\u003cstrong\u003eCancer literacy.\u003c/strong\u003e Positive and negative answers\u0026rsquo; interannual averages.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eCancer literacy\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eYes (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003eNo (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eKnowledge concerning the impact of diet and physical activity on cancer risk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eKnowledge concerning the benefits of fruit and vegetable intake against cancer risk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eKnowledge concerning the benefits of clean water intake against cancer risk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eKnowledge concerning the impact of sweetened drinks on cancer risk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eKnowledge concerning the impact of fast foods on cancer risk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eKnowledge concerning minimal amounts of physical exercise associated with reduced c\u0026aacute;ncer risk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eKnowledge concerning the benefits of not smoking tobacco against c\u0026aacute;ncer risk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eBeyond the specifics of that historical context, the obstacles to acquiring information to guide decisions on prevention, diagnosis, or treatment of different forms of cancer are pronounced at numerous levels in a structural capacity. This observation is consistent with and extends the findings of previous studies on the subject.\u003csup\u003e[57\u0026ndash;58]\u003c/sup\u003e The aforementioned drawbacks for users of the health system and some deficiencies in accessing the Internet (expressed by 3\u0026middot;73% SE 1\u0026middot;99 of people) are just two of the factors that explain a strongly unequal distribution of knowledge of critical importance in this area. The lack of knowledge about the general fact that diet and physical activity have an impact on the probability of acquiring some form of cancer, expressed by over half of the people surveyed (56\u0026middot;69% SE 4\u0026middot;23), is similar or even greater with regard to more specific associations, such as the lack of knowledge about the benefits of frequent intake of fruits and vegetables or of drinking clean water (54\u0026middot;77% SE 1\u0026middot;64 and 34\u0026middot;13% SE 11\u0026middot;65 in each case), or about the harm of consuming sweetened drinks (36\u0026middot;53% SE 6\u0026middot;75). Nor does information on the preventive advantages of reducing the consumption of fast food (32\u0026middot;86% SE 8\u0026middot;69 are unaware of them), the minimal amounts of physical exercise that have been shown to be associated with a reduced risk of cancer (only 44\u0026middot;02% SE 8\u0026middot;61 are aware of them) or the beneficial effect of not smoking tobacco (13\u0026middot;88% SE 7\u0026middot;88 are still unaware of them) seem to be sufficiently widespread (Table 3).\u003c/p\u003e\n\u003cp\u003eEqually deficient is access to knowledge about environmental factors that have consequences on cancer incidence, which was reported by only 65\u0026middot;23% SE 3\u0026middot;60 of the respondents. In particular, 38\u0026middot;98% (SE 7\u0026middot;37) did not know what agrotoxics were, despite the fact that over a quarter of those surveyed on this point were aware of being exposed to them (29\u0026middot;05% SE 23\u0026middot;05). The number of people who were unaware of the importance of early cancer detection for better treatment and lower lethality was in turn around 23\u0026middot;95% (SE 5\u0026middot;35). On the other hand, the perception of unmet needs in this area of knowledge also stood out among those surveyed: 94% (SE: 2\u0026middot;52) expressed the urgency for more information on one or several of these dimensions.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe proportion of female survey respondents was well above that of the autonomous popular high schools\u0026rsquo; student body.\u003csup\u003e[59]\u003c/sup\u003e The data shows a greater involvement of women and gender minorities in health issues, which confirms the consolidated findings referred to the majority place of this demographic among those who work both in public and private health systems\u003csup\u003e[60\u0026ndash;61]\u003c/sup\u003e and in social and non-governmental organizations involved in health issues and building care networks.\u003csup\u003e[62]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eSurvey results indicate a significant incidence of several risk factors related both to general health detriment and specifically to cancer. In terms of living conditions, residing in floodable zones and a lack of connection to public sewage systems were the most prevailing factors, while proximity to garbage dumps and a lack of connection to the drinking water network \u0026ndash;though less frequent\u0026ndash; displayed nonetheless alarming levels. The absence of connection to public networks, the use of well water and septic tanks may involve exposure to several contaminants present in the region's groundwater,\u003csup\u003e[63]\u003c/sup\u003e with well-established links to an increase in the incidence of different types of cancer. These are the cases of chromium,\u003csup\u003e[64]\u003c/sup\u003e arsenic,\u003csup\u003e[65\u0026ndash;67]\u003c/sup\u003e nitrates,\u003csup\u003e[68\u0026ndash;69]\u003c/sup\u003e and various pesticides.\u003csup\u003e[70\u0026ndash;71]\u003c/sup\u003e Some studies indicate that proximity to landfills significantly increases the incidence of some forms of cancer, particularly lung cancer, and landfills have been found to emit significant amounts of carcinogenic compounds into the air.\u003csup\u003e[72\u0026ndash;74]\u003c/sup\u003e On the other hand, each of these determinations is in turn an indirect indicator of life under conditions of poverty and social marginalization, which imply a worsening in the probabilities of early detection and survival in relation to several types of cancer, as is the case of breast cancer.\u003csup\u003e[75]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAs regards life-style risk factors which closely correlate to socio-economic determinations, stress levels, insufficient physical exercise, and dietary imbalances and deficits were also prominent. Both elevated stress levels and exiguous exercise have been linked to a higher incidence of cancer, while improvement in both has shown to better outcomes in diagnosed patients.\u003csup\u003e[76\u0026ndash;78]\u003c/sup\u003e In terms of diet, low levels of consumption of fruits and vegetables (with restricted access to organic or agro-ecological varieties), regular consumption of soft drinks and other industrial beverages, presumably unmet protein and fatty acids requirements, and frequent consumption of manufactured refined wheat-flour products and fast food were most common in our survey. In turn, tobacco and alcohol use remain well above desirable levels. If tobacco consumption is the longest established and most universally recognized carcinogenic determinant, there is already ample evidence of the impact of diet on the deterioration of health and the appearance of different forms of cancer in particular. Such is the case with diets high in fat, refined wheat flour, fried foods and refined sugars, unbalanced in omega-3 and omega-6, low in fiber, or with frequent alcohol intake.\u003csup\u003e[79\u0026ndash;83]\u003c/sup\u003e Inversely, there is a well-proven negative association with abundant intake of vegetables and fruits, and fish.\u003csup\u003e[81\u0026ndash;82]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe role of meat consumption in the field of prevention and reduction of the lethality of different forms of cancer is complex. On the one hand, red meat continues to be the protein source of choice in Argentine households,\u003csup\u003e[84]\u003c/sup\u003e so that its consumption levels bear the responsibility of covering the nutritional requirements of that type, necessary for general health maintenance and, specifically, for better prognoses among those undergoing aggressive oncological therapies.\u003csup\u003e[85]\u003c/sup\u003e On the other hand, red meat consumption has been solidly associated with increased colorectal cancer incidence.\u003csup\u003e[86]\u003c/sup\u003e Under these conditions, a scientifically based food policy, which in turn specifically addresses the prevention and reduction of cancer lethality, should probably include the guarantee of universal access to the meat consumption necessary to meet protein requirements, and at the same time a food education policy that makes possible their progressive replacement \u0026ndash; totally or partially \u0026ndash; by other sources of protein that are safer in the long term.\u003c/p\u003e \u003cp\u003eRelating our data concerning lifestyle factors to surveyed housing deficits and access to agroecological fruits and vegetables, as well as to registered income levels of the areas, reinforces the need posited by previous scholars to criticize the very notion of \u0026ldquo;lifestyle\u0026rdquo; in health studies and health promotion.\u003csup\u003e[87\u0026ndash;88]\u003c/sup\u003e Data on \u0026ldquo;lifestyle\u0026rdquo; is too often taken as the basis for recommendations for the individuals that fail to take into consideration structural dimensions strongly conditioning personal choices on diet, and the feasibility of regular exercise or stress-mitigating measures. Our study shows how underprivileged communities have globally deficient diets that far exceed individual choice and require collective solutions. The co-appearance of housing deficits and a lack of regular exercise could suggest that worse local infrastructure for physical activity hinders habits; further local research would be necessary to establish a precise correlation. Respondents also register in full-text sections several socioeconomic sources of stress that are specific to their living conditions. Altogether, sufficient data has been brought forth as to alert for the need to continue monitoring and effect urgent reparation and/or transformative measures on the matter in accordance with previous evidence and parameters.\u003csup\u003e[89\u0026ndash;91]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eData pertaining to access to health in the cancer-care continuum was likewise concern-provoking. Unmet demands of information regarding early detection, infrequent annual check-ups, and obstacles in the path towards diagnosis and treatment were rampant. That set of difficulties confirms the complex interaction between structural issues and the efforts made against all odds by individuals and their families or affective ecosystems to access care,\u003csup\u003e[92\u0026ndash;94]\u003c/sup\u003e in a scenario in which - as we saw - there is a well-established association between belonging to households with unmet basic needs and the proliferation of various forms of cancer.\u003csup\u003e[95\u0026ndash;96]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eHealth access numbers were dramatically worse during the COVID-19 pandemic, which raises alarms in the case of future socio-sanitary crises. Studies developed on a national scale or in other specific regions of the country on the situation of cancer health care during the pandemic\u003csup\u003e[34,97]\u003c/sup\u003e indicate concurrent results with several of these dimensions: an overall decrease in consultations, diagnoses, treatments, interventions, and hospitalizations; the de-prioritization of non-communicable diseases as a whole; the retraction of cancer screening programs that were already deficient; and a drop in the number of early detection-check-ups (between 56% and 79% depending on the type of cancer), diagnoses (between 84% and 87%) and, to a lesser extent, treatments (3% of people who already had a diagnosis). The scale of our research does not yet allow us to draw conclusions on the quantitative difference between one report and the set of others, but the congruence in the general patterns of decrease strengthens both.\u003c/p\u003e \u003cp\u003eThe global data suggest a similar trend, although the figures vary from country to country depending on the divergence in pandemic response paradigms and the baseline status of the respective medical systems; in some cases, the impact was offset by the installation of new medical centers and alternative diagnostic and treatment protocols that reduced the potential for transmission, given the increased incidence and lethality of COVID-19 in cancer patients.\u003csup\u003e[30,98\u0026ndash;104]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eDuring and beyond the pandemic, the detrimental effects of these deficits are compounded by significant gaps in health literacy regarding cancer risk factors of all nature, whereas reported avidity for further education and information on the subject allows for some prudent optimism. Previous research into health and cancer literacy in Argentina through hospital patients or general population had recorded gaps generally consistent with our findings, as well as some indicators of improvement over the last years;\u003csup\u003e[105\u0026ndash;108]\u003c/sup\u003e it has also advised against too strong a reliance on media campaigns, in favor of more community-centered, collaborative approaches.\u003csup\u003e[109\u0026ndash;110]\u003c/sup\u003e The perception of unmet information needs among our surveyed population represents a favourable opportunity for the future advancement of health education and promotion initiatives, encompassing the educational social practices that underpin these surveys, as well as other pertinent types. It is essential to ensure the provision of adequate material resources, organisational support, and institutional commitment to facilitate the active involvement of individuals within their respective communities as participants and co-protagonists in these endeavours.\u003c/p\u003e \u003cp\u003eOur results are to be interpreted with caution in reference to the sample size of the survey, imposed by the participatory nature of the research frame, but the final number of respondents remained above the amount suggested by the Raosoft sample size calculator. Furthermore, the output of the exploratory analysis offered in this report is robust in other aspects. Participatory action research produces data that is based on the solid interpersonal trust built along the investigative process amongst all involved actors, in a manner that is unattainable in large-scale surveys, which carries to the reliability of the answers themselves.\u003csup\u003e[41,111]\u003c/sup\u003e On the other hand, social protagonism during variable determination and data collection ensures usability for grassroots organization and advocacy, which in turn are crucial for the ethical justification of the research process.\u003csup\u003e[112]\u003c/sup\u003e While the emerging results may display some limitations towards certain precise quantitatively dependent conclusions, they are sufficiently methodologically solid to indicate tendencies, promote further specific research targets and foster multilevel collective processes, as has been reported in similarly devised studies.\u003csup\u003e[40]\u003c/sup\u003e Furthermore, these data have the potential to serve as a source of inspiration for other communities, universities and researchers, encouraging them to undertake a replication of this investigation with the aim of developing solutions.\u003c/p\u003e \u003cp\u003eA separate note is warranted regarding the availability of general data required to generate actionable, country-wide cancer statistics and to guide potential interventions in Argentina. Public records on cancer are historically lacking in terms of subregional disaggregated data, which impairs a specific analysis of how our evidence regarding risk factors impacts incidence and mortality rates. Epidemiological screening on incidence and mortality also lay beyond the scope of our own survey, following the research goals agreed with the local community actors. However, previous local studies have solidly established statistical correlations between our set of detrimental variables in risk patterns and actual incidence and mortality increases, be those the cases of environmental contaminants,\u003csup\u003e[113]\u003c/sup\u003e \u0026lsquo;lifestyle\u0026rsquo; characteristics,\u003csup\u003e[114\u0026ndash;115]\u003c/sup\u003e or health access deficits.\u003csup\u003e[116]\u003c/sup\u003e Research into the molecular mechanisms, particular immune alterations and the internal exposome of these populations \u0026ndash;such as the SPRINT initiative\u0026ndash;\u003csup\u003e[117]\u003c/sup\u003e continue to shed light on the causal pathways behind these correlations. While the State censorship of the results of the SPRINT project occurred in the previous administration,\u003csup\u003e[118]\u003c/sup\u003e since the national government of Javier Milei sanctioned the dissolution of the National Cancer Institute (INC) information availability will only worsen until tangible preventive health policies are deviced.\u003csup\u003e[119]\u003c/sup\u003e The destruction and/or defunding of public institutions devoted to health and research can only hinder collective efforts in cancer prevention, early detection and better treatment alternatives, cascading into the concrete experience of communities and patients.\u003c/p\u003e \u003cp\u003eEmerging recommendations\u003c/p\u003e \u003cp\u003eFrom the set of quantitative and qualitative knowledge produced throughout this participatory research project, a series of recommendations emerges to be taken into account by the different stakeholders involved in the problems addressed here. All of these recommendations are endorsed not only by the information gathered throughout the execution of the project reported in this paper, but also by the increasingly overwhelming evidence gathered by numerous scientific studies, many of which have been cited throughout, together with precautions established by court rulings.\u003csup\u003e[120]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eI. Recommendations to the Argentinean public administration in its different jurisdictions\u003c/p\u003e \u003cp\u003eTo avoid the persistent exposure of people to the set of socio-environmental determinants that have a proven correlation with the increase in the incidence of cancer, several measures need to be taken. Firstly, in order to prevent the imposition to the population of harmful concentrations of chemicals, it is imperative to prohibit the aerial application of agrochemicals at distances of less than 3,000 meters from homes and schools and the terrestrial application at distances of less than 1,095 meters; universal access to drinking water (without significant amounts of carcinogenic compounds) and sewage networks should be likewise guaranteed. The necessary infrastructure works to prevent natural flooding in inhabited areas must be carried out, and the authorizations granted for deforestation and sumptuary building that cause flooding due to human causes must be reevaluated. Local administration also needs to relocate garbage dumps or sanitary landfills to places where they do not affect the living conditions of the communities, and organize a comprehensive waste reduction policy that does not place the responsibility disproportionately on individuals and impoverished communities.\u003c/p\u003e \u003cp\u003eSecondly, as regards the consequences of living conditions over \u0026ldquo;lifestyle\u0026rdquo; available pathways, governments must guarantee the presence of green spaces suitable for physical exercise in all neighborhoods. They also need to promote, from an economic, educational, and technological standpoint, the development of large-scale agro-ecological agriculture, providing the means to make its products accessible to the entire population. That should fit into a comprehensive food policy that makes it possible to satisfy nutritional needs universally, considering the recommended levels of protein and fatty acid intake, and fruit and vegetable consumption.\u003c/p\u003e \u003cp\u003eIn terms of the health and education systems, administrations also hold the duty to implement cross-cutting and integrated programs between those systems that make effective access to information on cancer in its socio-environmental, dietary and lifestyle dimensions in general. They must strengthen the public health system in its capacity to provide access to prevention, early detection, diagnosis and treatment of cancer, as well as the social benefits that make possible the continuity of people's attendance to health centers. It is likewise crucial that they should support in institutional, economic and technological matters the work carried out by NGOs and grassroots organizations, and the scientific-technological and university system in terms of community access to information on cancer and its socio-environmental aspects.\u003c/p\u003e \u003cp\u003eII. Recommendations to health system workers\u003c/p\u003e \u003cp\u003eFor the workers who \u0026ndash;to high personal costs\u0026ndash; hold together the health system through their daily labor, the addressal of some emerging concerns is advisable. It is crucial to identify the obstacles that people encounter within health institutions for the early detection, diagnosis, and treatment of cancer, demanding where appropriate the competent authorities of each jurisdiction regarding the deficits in personnel, infrastructure, and equipment that this requires to be remedied. Local studies so far have identified great regional disparities in access to specialists and diagnostic technologies that have serious impact on delayed diagnosis.\u003csup\u003e[121\u0026ndash;123]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOur research also signals the relevance of participating in prevention campaigns in collaboration with NGOs, grassroots organizations and/or educational institutions, which address the social need for multidimensional information on cancer. Cross-sector initiatives that foster health promotion and prevention play a crucial role in risk reduction, where media campaigns have shown limitations. They should be regionally and culturally specific, equitable, and allow for social protagonism.\u003c/p\u003e \u003cp\u003eIII. Recommendations to members of the academic and educational communities\u003c/p\u003e \u003cp\u003eResearchers and educators should play a growingly active role in addressing regional specificities for cancer prevention and early detection. It is essential for us to actively participate in cooperation/co-production projects that highlight the local conditions in each territory with respect to the socio-environmental determinants of cancer. Cancer literacy also requires more educational inputs for the general public and for professionals in the various branches concerned that articulate in an integrated manner the various dimensions of cancer.\u003c/p\u003e \u003cp\u003eResearch agendas and health upper education on cancer have predominantly focused too exclusively on biomedical aspects, neglecting socio-environmental dimensions and multidimensional approaches to prevention.\u003csup\u003e[124]\u003c/sup\u003e This reflects trends in the hegemonic medical model and the scientific dominant discourse that both lack a holistic approach to health and are highly determined by private-sector profit seek, resulting in the marginalization of the health of underprivileged communities.\u003csup\u003e[3,6,125]\u003c/sup\u003e These trends urgently need to be counterbalanced in general and in cancer research and education in particular.\u003c/p\u003e \u003cp\u003eIV. Recommendations to NGOs and grassroots organizations concerned with health and socio-environmental issues\u003c/p\u003e \u003cp\u003eIt is advisable for these groups to sustain and strengthen the work carried out jointly with other social and institutional actors in socio-environmental and health education, requiring, when necessary, the collaboration of workers from the health system and the scientific and university systems, and the resources of different types that this demands.\u003c/p\u003e \u003cp\u003eNGOs and grassroots organizations have also been key actors in agro-ecological food production and environmental remediation in the last decades.\u003csup\u003e[127\u0026ndash;129]\u003c/sup\u003e Their remarkable work needs to be sustained and strengthened, supported, when necessary, by the collaboration of workers from the agricultural promotion administration and the scientific and university systems, and the resources of different types that this may demand. Only equitable cross-sectorial collaboration and resource allocation can allow for effective implementation.\u003c/p\u003e"},{"header":"Declarations","content":" \u003cp\u003eEthics declaration\u003c/p\u003e \u003cp\u003eThis study formed part of the protocol \u0026ldquo;Assessment of the impact of the COVID-19 pandemic on the diagnosis and treatment of cancer patients\u0026rdquo; evaluated and approved by the Research Ethics Committee of the Alexander Fleming Institute (IAF), Argentina in accordance with the relevant guidelines and regulations of the Resolution 1480/2011 of the former Argentinian National Ministry of Health and the Declaration of Helsinki.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent to Participate\u003c/strong\u003e \u003cp\u003eThe participatory survey was designed and conducted collaboratively between researchers and local actors. At the beginning of the online survey, an informed consent text was included, detailing the voluntary acceptance of completing the data, the purpose, anonymity, and data management. Completing the survey implies the participants' consent (Faculty of Social Sciences, University of Buenos Aires). In this regard, informed consent was obtained from all participants. The cycles of self-administered online surveys were conducted on a voluntary and anonymous basis. All data of the participants were kept confidential and used only for research and scientific purposes.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent to Publish\u003c/strong\u003e \u003cp\u003eNot applicable.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCompeting interests\u003c/strong\u003e \u003cp\u003eThe author(s) declare(s) that they have no competing interests.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThe work was funded by grants for interdisciplinary research and university outreach programs from the Universidad de Buenos Aires (PIUBAS and UBANEX) and the Secretariat of University Policies of the former Argentine Ministry of Education (Voluntariado Universitario and Universidad, Cultura y Territorio). The funding sources had no involvement in study design; collection, analysis, and interpretation of data; in the writing of the report; nor in the decision to submit the paper for publication.\u003c/p\u003e \u003cp\u003eClinical trial number: not applicable.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eWe declare no competing interests.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe would like to express our sincere gratitude to all the students, teachers, and neighbors who participated in this work, as well as to Federico Waisberg (IAF), who collaborated on medical aspects and contributed to the development of the protocol and the evaluation by the ethics committee. Matias Blaustein and Natalia Rubinstein are members of CONICET. Francisco Gelman Constantin was supported by a postdoctoral fellowship from the Agencia I + D + I during the research process. Mercedes Garc\u0026iacute;a Carrillo was supported by a postdoctoral fellowship from CONICET and by a full-time teaching assistant position from the University of Buenos Aires. Mar\u0026iacute;a Sof\u0026iacute;a Amarilla was supported by a doctoral fellowship from CONICET.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003e1Siegel RL, Kratzer TB, Giaquinto AN, Sung H, Jemal A. 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Global agri-food chains in times of COVID-19: the state, agribusiness, and agroecology in Argentina. \u003cem\u003eJ Agrar Change.\u003c/em\u003e 2021;21(3):629\u0026ndash;37. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/joac.12418\u003c/span\u003e\u003cspan address=\"10.1111/joac.12418\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8716293/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8716293/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study analyzes the results of a survey conducted among students and neighbors from autonomous education institutions in Argentina, focusing on socio-environmental factors influencing cancer risk, to spotlight conditions specific to these communities and produce actionable data.\u003c/p\u003e \u003cp\u003eThe study consisted of a participatory survey through local autonomous high-schools in four yearly cycles, within three underprivileged neighborhoods around Buenos Aires (Argentina). The survey process was designed and conducted collaboratively between researchers and local actors, using Google Forms. Results were subjected to descriptive statistical analysis.\u003c/p\u003e \u003cp\u003eThe survey was administered between April 2021 and April 2025 to 173 individuals (124 female and non-binary, 49 male). Results revealed sizeable housing deficits: 33\u0026middot;3% (SE 8\u0026middot;95, p\u0026thinsp;=\u0026thinsp;0\u0026middot;0196) lacked public sewage access, 19\u0026middot;69% (SE 3\u0026middot;10, p\u0026thinsp;=\u0026thinsp;0\u0026middot;0252) lacked potable water, and many lived near garbage dumps (26\u0026middot;28%, SE 3\u0026middot;00, p\u0026thinsp;=\u0026thinsp;0\u0026middot;0011) or flood zones (38\u0026middot;26%, SE 6\u0026middot;37, p\u0026thinsp;=\u0026thinsp;0\u0026middot;0044), which increased exposure to carcinogens. Socioeconomic conditions contributed to unhealthy lifestyles: 85\u0026middot;61% (SE 0\u0026middot;73, p\u0026thinsp;=\u0026thinsp;0\u0026middot;0002) reported medium-high stress, 40\u0026middot;8% (SE 6\u0026middot;22, p\u0026thinsp;=\u0026thinsp;0\u0026middot;1178) lacked physical activity, and diets were poor in fruits/vegetables and proteins (37\u0026middot;19% SE: 9\u0026middot;35, p\u0026thinsp;=\u0026thinsp;0\u0026middot;1322 and 35\u0026middot;05% SE 6\u0026middot;73, p\u0026thinsp;=\u0026thinsp;0\u0026middot;04072, respectively), while high in processed foods (85\u0026middot;01% SE 3\u0026middot;64 p\u0026thinsp;=\u0026thinsp;0\u0026middot;0027) and alcohol (8\u0026middot;28% SE 2\u0026middot;75, p\u0026thinsp;=\u0026thinsp;0\u0026middot;0003). Only 47\u0026middot;27% (SE 9\u0026middot;38, p\u0026thinsp;=\u0026thinsp;0\u0026middot;0432) received timely information on early cancer detection.\u003c/p\u003e \u003cp\u003eThese results highlight structural inequalities in environmental conditions, lifestyle factors, and healthcare access, underscoring the urgent need for targeted health education and systemic interventions. Given the global rise in cancer incidence\u0026mdash;particularly in marginalized populations\u0026mdash;, this research emphasizes the urgent need to examine how socioeconomic, environmental, and health system factors impact cancer risk in low-income communities.\u003c/p\u003e","manuscriptTitle":"Participatory Research on Cancer Risk and Public Health in Argentina","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-16 17:48:29","doi":"10.21203/rs.3.rs-8716293/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fee6221d-96d2-4594-a7e9-97884a9ba367","owner":[],"postedDate":"April 16th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-16T17:48:29+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-16 17:48:29","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8716293","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8716293","identity":"rs-8716293","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}