Lung cancer screening in transition: highlights from the 3rd Oslo Lung Cancer Symposium, 2025

The 3rd Annual Lung Cancer Symposium (Oslo Cancer Cluster, 25 September 2025) gathered experts from all the Nordic countries, Norway, Finland, Iceland, Denmark, Sweden, as well as Germany, the UK and the USA to present new evidence and implementation experiences in low-dose chest tomography lung cancer screening, with cross-cutting attention to risk stratification, health economics, AI-enabled workflows, and equity. The symposium was organized by Oslo Cancer Cluster, Levanger Hospital and the Norwegian University of Science and Technology, as a continuation of previous years´ annual efforts to gather and showcase the experiences and the progress of the Nordic countries with lung cancer screening. Across settings, LDCT screening is associated with stage shift and potential mortality reduction, consistent with large trials (NLST, NELSON) and maturing real-world experience (HANSE pilot study, programs in Croatia, Taiwan, the UK, and the US). Emerging Nordic pilots demonstrate feasibility, early-stage detection, and high adherence, while European coordination (SOLACE) is accelerating guideline harmonization and implementation pilots. Key themes included: (1) superiority of multivariable risk models over categorical criteria; (2) the necessity of integrating smoking cessation; (3) program economics that are likely acceptable under Nordic decision thresholds; (4) capacity and downstream pathway planning; and (5) equity-by-design to avoid widening disparities. This report synthesizes country updates and implications for Nordic and European scale-up.