Implementation of lung cancer screening: an European survey

Abstract

<b>Background:</b> population-based lung cancer screening (PBLCS) by low dose Ct-scan is recommended by several scientific societies and advocated by the EU commission. The status of its implementation in Europe remains unclear. <b>Aim:</b> to survey the pick-up of PBLCS&nbsp;in Europe <b>Methods:</b> semi-structured survey by e-mail among expert KOL9s&nbsp;of 32 European countries, addressing the status and&nbsp;hurdles for implementing a&nbsp;PBLCS in their country. <b>Results:</b> Replies were obtained from&nbsp;22 countries. In none but one (Croatia), a formal PBLCS is ongoing.&nbsp;In half of the countries&nbsp;large scale feasibility pilots are being conducted. A formal EU recommendation is required in 3 countries. The implementation and regulatory policy is well defined in 58% of countries. A&nbsp;local cost-effectiveness&nbsp;analysis (CEA) has been&nbsp;published in&nbsp;5/21&nbsp;countries. In half of the countries, this CEA is compulsory for PBLCS to be implemented. The costs of a PBLCS will be covered by either the&nbsp;NHS (55%) or national authorities (30%). The health minister is (co-)invested with the decision to start a PBLCS in 76%. Association with a structured smoking cessation programme is (very) likely in&nbsp;71% of countries. Cost and capacity of Ct-scans and radiologists are considered the main hurdles for future implementation, rather than the stigma of lung cancer or the willingness of radiologists. <b>Conclusion:</b> Implementation of PBLCS in Europe is variable and fragmented, with half of the countries likely to start it in the next 5 years, provided cost and capacity issues are appropriately addressed.