SETTING: While carcinogenic exposures affect half of European workers, occupational cancers remain strongly underreported. In France, the occupational diseases (OD) compensation system is ill-adapted for cancer patients, leaving work-related cancers socially and politically invisible. The identification of patients with occupational cancer and their support in compensation claims are neglected aspects of cancer care. INTERVENTION: Since 2018, GISCOPE 84 runs a two-tiered intervention: 1. A cohort-like survey with blood cancer (non-Hodgkin's lymphoma and myeloma) patients diagnosed at the Vaucluse Regional Hospital Group, which follows four steps: (1) systematic invitation to participate to all newly diagnosed patients, (2) detailed interview-based reconstruction of participating patients' work histories, (3) assessment of exposures to 65 carcinogens by a multidisciplinary expert group and referral of eligible patients to an OD claim, (4) provision of socio-administrative support by a hospital social worker and follow-up of patients' OD claim procedures. 2. A strategy aimed at prompting broader change through professional training, multi-stakeholder collaboration, and proactive policy advice. OUTCOMES: The intervention generated differential effects following a concentric-circle pattern of diminishing intensity, with strong impacts on directly affected patients (notably, a stark increase in OD recognition rates), moderate impacts on directly involved institutional stakeholders, and only weak effects on the national regulatory framework and institutional practices. IMPLICATIONS: To prompt more structural change, GISCOPE 84 now aims to develop a transferable framework for the detection and support of patients with occupational blood cancer. This framework would be integrated into coordinated care pathways and tested in three different hospital settings to assess its transferability and potential for scale-up.
Hunsmann et al. (Sun,) studied this question.