Implementing Lung Cancer Screening in Europe: Taking a Systems Approach

Suzanne Wait*, Arturo Alvarez-Rosete, Tasnime Osama, Dani Bancroft, Robin Cornelissen, Ante Marušić, Pilar Garrido, Mariusz Adamek, Jan van Meerbeeck, Annemiek Snoeckx, Olivier Leleu, Ebba Hallersjö Hult, Sébastien Couraud, David R. Baldwin

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

23 Citations (Scopus)
31 Downloads (Pure)

Abstract

Lung cancer is the leading cause of cancer death in Europe. Screening by means of low-dose computed tomography (LDCT) can shift detection to an earlier stage and reduce lung cancer mortality in high-risk individuals. However, to date, Poland, Croatia, Italy, and Romania are the only European countries to commit to large-scale implementation of targeted LDCT screening. Using a health systems approach, this article evaluates key factors needed to enable the successful implementation of screening programs across Europe. Recent literature on LDCT screening was reviewed for 10 countries (Belgium, Croatia, France, Germany, Italy, the Netherlands, Poland, Spain, Sweden, and United Kingdom) and complemented by 17 semistructured interviews with local experts. Research findings were mapped against a health systems framework adapted for lung cancer screening. The European policy landscape is highly variable, but potential barriers to implementation are similar across countries and consistent with those reported for other cancer screening programs. While consistent quality and safety of screening must be ensured across all screening centers, system factors are also important. These include appropriate data infrastructure, targeted recruitment methods that ensure equity in participation, sufficient capacity and workforce training, full integration of screening with multidisciplinary care pathways, and smoking cessation programs. Stigma and underlying perceptions of lung cancer as a self-inflicted condition are also important considerations. Building on decades of implementation research, governments now have a unique opportunity to establish effective, efficient, and equitable lung cancer screening programs adapted to their health systems, curbing the impact of lung cancer on their populations.

Original languageEnglish
Article number100329
JournalJTO Clinical and Research Reports
Volume3
Issue number5
DOIs
Publication statusPublished - May 2022

Bibliographical note

Funding Information: The initial research and drafting of this article were conducted by The Health Policy Partnership with financial support from AstraZeneca, who were also invited to comment on the article. None of the other co-authors received any compensation for their contributions to this article.

Publisher Copyright: © 2022 The Authors

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