Lung cancer screening in Europe: how do we make access fair?

Europe is moving forward with lung cancer screening.

More countries are progressing from pilot programmes towards implementation. A new report from the Lung Cancer Policy Network looks at what early adopters are learning and what needs to happen if screening is to reach the people most likely to benefit.

Lung Cancer Europe is a member of the Lung Cancer Policy Network, a global multidisciplinary network that brings together clinicians, researchers, patient organisations and other organisations working in lung cancer. Its outputs are evidence-based, non-promotional and shaped by its members.

The new report, Advancing lung cancer screening: learning from implementation in Europe, focuses on four practical areas: reaching people at highest risk, reducing barriers to participation, integrating smoking cessation support and making sure health systems can deliver screening at scale.

Why is lung cancer screening important?

Lung cancer is still often diagnosed at a later stage, when treatment options can be more limited.

Screening aims to find lung cancer before symptoms develop in people at increased risk. It uses low-dose computed tomography, usually called LDCT.

Evidence shows that LDCT screening can reduce deaths from lung cancer in people at higher risk. Lung Cancer Europe’s 9th Report describes screening as one of the key ways to support earlier diagnosis.

But showing that screening works is only part of the job.

Countries also need to decide who should be invited, how people will be reached, how easy it is to take part and what happens when a scan finds something that needs further investigation.

Who should be offered lung cancer screening?

One of the first challenges is identifying the people most likely to benefit.

Age and smoking history are commonly used to decide who is eligible. The new report recommends going further by considering multivariable risk models, which use several factors to estimate a person’s risk.

This can help programmes identify people at higher risk more accurately and reduce disparities in who is selected for screening.

What stops people taking part in screening?

Being eligible for screening does not mean someone will take part.

How people are invited, the information they receive, where screening is offered and how easy appointments are to attend can all affect participation.

The report recommends organised, population-based invitations alongside more targeted outreach for groups that may otherwise be underserved.

This is particularly important because screening programmes should reduce inequalities, not widen them.

Why include smoking cessation support?

The report also recommends integrating smoking cessation support into screening pathways.

Screening and smoking cessation have different purposes.

Screening aims to find lung cancer earlier. Smoking cessation reduces the future risk of lung cancer and many other diseases.

Offering smoking cessation support alongside screening can increase the overall health benefit of the programme and improve cost-effectiveness.

Can health systems support screening at scale?

A screening programme cannot stop at the scan.

Health systems need clear processes for managing lung nodules and other findings, enough diagnostic capacity for people who need further tests, suitable digital systems and strong quality assurance.

There also needs to be enough capacity further along the pathway so that people can move quickly from an abnormal scan to diagnosis and, where needed, treatment.

The new report argues that screening therefore needs to be properly integrated into health systems from the start.

How much do people know about lung cancer screening?

Access is only part of the issue. Awareness also remains low.

Lung Cancer Europe’s 9th Report on Lung Cancer surveyed more than 2,000 people affected by lung cancer across Europe.

Only 40.6% correctly identified what lung cancer screening is.

Almost 45% did not know whether there was a lung cancer screening programme in their own country.

The report also found that 27.4% thought lung cancer screening was for people who were already experiencing symptoms.

That distinction is important. Screening is designed for people at increased risk who do not have symptoms. Someone who has possible symptoms of lung cancer needs diagnostic assessment, not screening.

Why equitable access to lung cancer screening is important

Countries across Europe are at different stages of introducing lung cancer screening, and access remains uneven.

For Lung Cancer Europe, timely and equitable access to screening is a clear policy priority.

Our 2026–2030 Charter calls for timely access to evidence-based screening and early detection programmes, so cancer is found as early as possible. Our wider advocacy priorities also call for screening programmes to expand and for inequalities in lung cancer outcomes across Europe to be reduced.

As more countries move towards implementation, the practical decisions being made now will affect who is reached and who benefits.

The experience brought together in this new report gives policymakers, healthcare professionals and advocates useful evidence on how screening can be delivered fairly and effectively across different health systems.

Source: Lung Cancer Policy Network. Advancing lung cancer screening: learning from implementation in Europe. Published 25 August 2026.