The case for low-dose computed tomography (LDCT) screening is settled. The evidence that targeted screening detects lung cancer earlier, shifts diagnosis to more treatable stages and reduces mortality is robust and widely accepted. Lung cancer screening is now recognised in Europe’s Beating Cancer Plan, EU Council recommendations and the European Code Against Cancer.
The question facing European health systems now is how to build programmes that are high-quality, equitable, scalable and sustainable. Countries across Europe are confronting that challenge in real time, moving from pilots and demonstration projects to national implementation. In doing so, they are generating a growing body of practical knowledge about what works, what does not and what others can learn from their experience.
This report captures those lessons.
Resources
Advancing lung cancer screening: learning from implementation in Europe
DownloadFour lessons from European implementation
Drawing on experiences from screening programmes, pilots and experts across Europe (including Croatia, England, Estonia, Germany and Poland) the report identifies four lessons that cut across different health system contexts:
- Tailor eligibility criteria to reach people at highest risk – age and smoking status are widely used, but multivariable risk models better identify high-risk individuals, improve screening efficiency and reduce selection disparities.
- Develop targeted outreach to improve participation – effective programmes combine systematic population-based invitations with outreach tailored to underserved groups.
- Amplify impact by integrating screening into broader public health initiatives – embedding smoking cessation support within screening pathways maximises health benefit and cost-effectiveness.
- Ensure full integration into health systems – earlier detection only delivers its full benefit when the system can act on what it finds; that requires nodule management protocols, digital infrastructure, quality assurance frameworks and investment in downstream diagnostic and treatment capacity.
Our report
This report develops on the Network’s inaugural report on screening implementation, updated to reflect the rapidly evolving European policy and implementation landscape.
It is designed as both a practical guide and a repository of lessons from the front line of delivery – useful whether you are shaping national policy, designing a programme or making the advocacy case for screening investment.
The report addresses:
- the policy, governance and funding conditions that enable effective implementation
- how eligibility criteria can be tailored to different health system contexts and population profiles
- strategies for reaching high-risk and underserved populations
- how to integrate screening with smoking cessation and other public health programmes
- what full health system integration requires and why it is essential to realising the benefits of screening.