Prospective construction of carcinogenic risk scenarios using MICMAC and Régnier Abacus: an approach for health decision-making.
DOI:
https://doi.org/10.64149/J.Carcinog.23.1.499-513Keywords:
Complex systems; health governance; structural prevention; prospective analysis; institutional sustainability; environmental vulnerability; regulatory policy; public resilienceAbstract
Introduction: Cancer can be considered a complex phenomenon with interactions among environmental, occupational, social, and political factors. Understanding the nature of these links requires models that transcend traditional causal analysis and allow for the prediction of future risk structures. This work develops a prospective structural approach to carcinogenic risks, combining structural analysis methods as instruments for health decision-making based on anticipation.
Methods: A prospective, structural, exploratory, and descriptive study was conducted in three phases. First, documentary and bibliometric reviews were carried out to identify associated variables, with the most relevant variables being selected through expert consensus. Next, the MICMAC structural analysis (Multiplication Cross-Impact Matrix Applied to a Classification) was used to determine the hierarchy of influence or dependence among variables. Finally, the Régnier Abacus was used to assess the probability and desirability of evolutionary hypotheses, constructing plausible scenarios for the period 2024–2034.
Results: The predominance of institutional factors over biological ones was evident. Environmental governance, regulatory compliance, and coverage shaped the context of carcinogenic risk. Coherence analysis showed a correlation between social desire and institutional feasibility, allowing for the definition of three contrasting scenarios. The results also indicate that it is necessary to strengthen anticipation and coordination by health systems in the face of risks of a multi-causal nature.
Conclusions: The integrated use of the MICMAC technique and Régnier Abacus demonstrated that structural risk anticipation can become a tool for health governance. Reducing carcinogenic risk depends more on policy coherence, regulatory compliance, and public perception of risk than on technological interventions. Applied prospective allows for translating complexity into strategies and guide decisions toward more resilient, equitable, and sustainable scenarios
