Implementing Lung Cancer Screening in Europe: Taking a Systems Approach

Area of Science:

• Public Health
• Oncology
• Health Systems Research

Background:

• Lung cancer is the leading cause of cancer death in Europe.
• Low-dose computed tomography (LDCT) screening can detect lung cancer earlier and reduce mortality in high-risk individuals.
• Currently, only a few European countries are implementing large-scale LDCT screening programs.

Purpose of the Study:

• To evaluate key factors for successful implementation of lung cancer screening programs across Europe using a health systems approach.
• To identify potential barriers and facilitators for widespread LDCT screening adoption.

Main Methods:

• A literature review of LDCT screening in 10 European countries.
• 17 semistructured interviews with local experts.
• Mapping research findings against an adapted health systems framework.

Main Results:

• European policy landscapes for lung cancer screening are highly variable.
• Common barriers to implementation exist across countries, similar to other cancer screening programs.
• Essential system factors include data infrastructure, equitable recruitment, workforce capacity, integration with care pathways, and smoking cessation support.

Conclusions:

• Effective, efficient, and equitable lung cancer screening programs require a comprehensive health systems approach.
• Addressing system-level factors and societal perceptions is crucial for successful implementation.
• Governments have an opportunity to curb lung cancer impact through adapted screening programs.