More people are living for years, even decades, after a cancer diagnosis, but what does that mean for healthy ageing? In this article, Mette Bach Larsen, Project Manager at the Lillebaelt Hospital, a project partner in the Joint Action Prevent Non-Communicable Diseases, explains why healthy ageing must include life after cancer, so that survivors and their families can not only live longer, but live well.Â
Cancer is no longer the end of the story, but part of a longer life course
In 2020, an estimated 23.7 million people in Europe were living after a cancer diagnosis, 40% more than a decade earlier. More than nine million had lived for at least ten years after diagnosis. This is one of the great successes of modern cancer care. But it also changes the questions we need to ask.Â
For a growing number of people, cancer is not only a life-threatening disease. It becomes part of a much longer life course. After treatment, people continue to age, develop other chronic conditions and live with the possible long-term consequences of cancer and its treatment, while multimorbidity is also common among cancer survivors.Â
As the number of people living for many years after cancer continues to grow, life after cancer must become part of how we think about healthy ageing. Â
Healthy ageing starts long before old age
A life-course perspective reminds us that healthy ageing does not begin in old age. Health and wellbeing develop across different stages of life and are connected over time.Â
Cancer makes this particularly visible. A diagnosis at 45, 55 or 65 may become a key event in a person’s health trajectory. Treatment can affect physical functioning and mental wellbeing, while lifestyle, social circumstances and other chronic conditions continue to shape health.Â
Prevention therefore remains relevant after cancer. A meta-analysis involving more than 200,000 cancer survivors found that healthier combinations of lifestyle behaviours were associated with lower mortality and cardiovascular disease.Â
This means that we need to broaden our idea of cancer prevention: from preventing cancer to also protecting and promoting health after cancer.Â
Health literacy goes beyond individual responsibility
Life after cancer often requires people to make new decisions about their health: how to manage long-term effects, maintain healthy behaviours, recognise when to seek help and find the right support. This requires health literacy — the ability to find, understand, assess and use health information and navigate available services.Â
But the ability to act on health information does not depend on the individual alone. Fatigue may make physical activity difficult, support may be hard to access, and fragmented services may be difficult to navigate. And importantly, these barriers are not equally distributed. People differ in the resources, opportunities and support they have available, meaning that prevention after cancer may reinforce rather than reduce existing health inequalities.Â
Supporting healthy ageing after cancer therefore requires more than providing information or strengthening individual health literacy. It also requires healthcare systems that identify people’s needs and make preventive support accessible and easier to navigate.
Making health systems easier to navigate
The Joint Action Prevent Non-Communicable Diseases (JA PreventNCD) is exploring different approaches to supporting healthy ageing after cancer. Â
 In Finland, an intervention for adults aged 30–65 after cancer treatment combines an eight-week online programme with group discussions, peer support and professional coaching, addressing physical activity and nutrition alongside mental wellbeing, sleep and recovery. Its focus on working-age adults illustrates an important point: healthy ageing starts long before old age.Â
 In Denmark, ‘Cancer Clock – Crossing Sectors’ starts with the person’s needs. Lillebaelt Hospital is developing and testing a clinical pathway to systematically identify complex physical, psychological, economic and social needs and organise responses through a stepped-care approach and stronger cross-sector collaboration.Â
 In these initiatives, rather than expecting people to find their own way through complex services, the healthcare system takes greater responsibility for identifying and responding to needs. Health literacy is not only about making people better at navigating health systems. It is about making health systems easier to navigate.Â
Cancer also happens to families
Partners, relatives and friends of cancer patients often become informal caregivers, providing practical and emotional support. Yet they are frequently seen primarily as a resource for the patient rather than as people with their own health needs and trajectories. Research on post-treatment interventions points to the need for more comprehensive support that considers patients and families together.
The PREV-CARE initiative within JA PreventNCD turns the prevention lens towards informal cancer caregivers. In France, Italy, and Germany, the ongoing initiative is developing and adapting support and prevention for caregivers and assessing feasibility and acceptability across contexts, while considering health inequalities too.Â
If cancer can shape the health trajectories of families as well as patients, equitable healthy ageing requires us to consider those who share the cancer journey, including families and informal caregivers.
From surviving cancer to ageing well
Together, these approaches suggest a broader understanding of prevention: one that moves from treatment to living well, from disease to people’s wider needs, from patient to family, and from preventing cancer to supporting health across the life course.Â
People need knowledge and skills to make informed decisions about their health. But health literacy alone cannot overcome fragmented services or unequal opportunities for healthy living.Â
Cancer can disrupt a person’s health trajectory, sometimes relatively early in adult life. But it may also offer an opportunity to identify needs, provide preventive support and create better conditions for health in the years ahead. The same perspective extends beyond cancer and holds for other major non-communicable diseases. If healthy ageing is our ambition, people living after major diseases — and their families — must have equitable opportunities not only to live longer, but to live well throughout the years that follow.Â
Keep on readingÂ
The Joint Action Prevent Non-Communicable Diseases (JA PreventNCD) project was designed to address the growing burden of cancer and non-communicable diseases by supporting strategies and policies that aim to reduce the burden of cancer and NCDs, focusing on both personal and societal risk factors.
Mette Bach Larsen
Mette Bach Larsen, MScPH, PhD, is a Project Manager and researcher at Lillebaelt Hospital, Denmark. She has extensive experience in cancer prevention, early detection, health services research and implementation science. Her research focuses on developing and evaluating person-centred approaches to cancer prevention and care, with particular emphasis on equitable access, reducing health inequalities and improving health outcomes across the life course. She is involved in several national and European research initiatives, including the EU Joint Action Prevent Non-Communicable Diseases (JA PreventNCD), working to translate research into sustainable improvements in healthcare.