Advancing women’s health equity in cancer screening: A conceptual framework from determinants to action

Cancer remains a leading cause of death among women globally, yet persistent gender gaps continue to limit the availability, accessibility, and effectiveness of cancer screening in real-world settings. Grounded in the multidimensional health ecological model, we propose a women-centered WHOLE conceptual framework to advance the gender-equitable implementation of cancer screening. This framework encompasses five interrelated components that span distal to proximal factors: Welfare Policy, Hybrid Screening Modalities, Operational Workforce, Lifestyle Integration, and Engagement. By moving beyond fragmented factors of screening access, WHOLE could provide a practical pathway that integrates influences across multiple levels, from individual motivation to the broader policy environment. It offers a novel paradigm for implementing equitable screening programs and improving women’s health outcomes globally.