In recent years there has been a growth in the role of prevention in controlling the disease burden. Increasing efforts have been conveyed in the screening implementation and public health policies, and the spreading knowledge on risk factors reflects on major attention to health checks. Despite this, lifestyle changes are difficult to be adopted and the adherence to current public health services like screening and vaccinations remains suboptimal. Additionally, the prevalence and outcome of different chronic diseases and cancers is burdened by social disparities. P4 [predictive, preventive, personalized, participatory] medicine is the conceptualization of a new health care model, based on multidimensional data and machine-learning algorithms in order to develop public health intervention and monitoring the health status of the population with focus on wellbeing and healthy ageing. Each of the characteristics of P4 medicine is relevant to occupational medicine, and indeed the P4 approach appears to be particularly relevant to this discipline. In this review, we discuss the potential applications of P4 to occupational medicine, showing examples of its introduction on workplaces and hypothesizing its further implementation at the occupational level.

Background: Gastric cancer (GC) incidence is declining heterogeneously worldwide. We aimed to calculate updated mortality trends for GC.Methods: We investigated time trends for selected countries using the World Health Organization database. We computed age‐standardized mortality rates (ASMR) per 100,000 persons over the 1990–2019 period. We reported rates for the 2010–2014 and 2015–19 calendar periods, and the corresponding percent changes. We used joinpoint regression analysis to identify changes in the slope of mortality trends, and predict the number of deaths and rates for 2025. We also reported 2008–2012 incidence rates of cardia and noncardia GC.Results: Mortality trends from GC have been favorable since 1990 for all countries analyzed and the European Union (EU 27), in both sexes and all ages. GC mortality is predicted to decline in all countries for both sexes, except for French and US women aged 35–64 years, and Canadian men aged 35–64. The highest proportions of cardia GC were observed in Northern and Central Europe while the lowest ones in Southern and Eastern Europe. Elsewhere, the highest proportions were registered in countries with low incidence and mortality rates, whereas high‐mortality countries showed lower proportions of cardia GC.Conclusion: Observed and predicted GC mortality trends declined in most countries in both sexes, with few exceptions, likely due to the control of GC risk factors, in particular Hp infection.

The implementation of primary and secondary preventive strategies is based on the evidence generated by cancer epidemiology, where the identification of risk factors and the description of their prevalence are fundamental to derive estimates on the burden of cancer from different etiologies, typically expressed as the population attributable fraction, which corresponds to the proportion of a cancer that may be prevented by controlling a given risk factor. However, even when cancer finds its etiology in modifiable factors, its prevention through the control of those factors is not always feasible, or it remains suboptimal despite the possibility of reducing the burden. We reviewed selected associations between modifiable risk factors and cancer, including tobacco smoking, occupational exposures, infections, air pollution, alcohol, and diet and obesity, and illustrated examples of both successes and failures in cancer control, underlying how current understanding of the avoidable causes of cancer is incomplete.