TY - JOUR
T1 - Implementing Lung Cancer Screening in Europe
T2 - Taking a Systems Approach
AU - Wait, Suzanne
AU - Alvarez-Rosete, Arturo
AU - Osama, Tasnime
AU - Bancroft, Dani
AU - Cornelissen, Robin
AU - Marušić, Ante
AU - Garrido, Pilar
AU - Adamek, Mariusz
AU - van Meerbeeck, Jan
AU - Snoeckx, Annemiek
AU - Leleu, Olivier
AU - Hult, Ebba Hallersjö
AU - Couraud, Sébastien
AU - Baldwin, David R.
N1 - 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
PY - 2022/5
Y1 - 2022/5
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85130785617&partnerID=8YFLogxK
U2 - 10.1016/j.jtocrr.2022.100329
DO - 10.1016/j.jtocrr.2022.100329
M3 - Review article
C2 - 35601926
AN - SCOPUS:85130785617
SN - 2666-3643
VL - 3
JO - JTO Clinical and Research Reports
JF - JTO Clinical and Research Reports
IS - 5
M1 - 100329
ER -