Lung Cancer Screening in Adults: State-of-the-Art and Policy Mapping (2025)

Background/Objectives: Lung cancer is the leading cause of cancer-related mortality in Europe, and most cases are diagnosed at an advanced stage. Screening with low-dose computed tomography (LDCT) has been shown to reduce lung cancer mortality in high-risk populations, and the 2022 EU Council Recommendation promotes the implementation of structured population-based screening. This systematic review provides a structured, cross-sectional policy mapping of the current landscape of lung cancer screening (LCS) strategies in adults in the 27 EU Member States and 3 non-EU European countries, based on information available up to July 2025. Methods: A structured policy mapping was conducted using data collected up to July 2025 from the National Screening Observatory, the WHO, national health authorities, and peer-reviewed literature to assess national LCS policies across 27 EU Member States and 3 non-EU European countries (Norway, Switzerland, and the United Kingdom). Results: LDCT-based LCS is implemented in 7 EU countries (25.9%), including one country with an implemented national program (Croatia), one with an authorized national program under rollout (Germany), and five conductive structured pilot programs (Czechia, Poland, Italy, Hungary, and Spain). Among the non-EU countries, 1 of 3 (33.3%), the United Kingdom, has a national program. All initiatives use LDCT as a screening modality, generally with annual intervals. The remaining countries have no organized LCS, although several have announced upcoming pilot studies. Conclusions: A progressive expansion of LDCT screening is emerging in Europe; however, significant variability across national policies persists. Harmonized, evidence-based strategies are needed to support broader implementation and ensure equitable access to early detection.