Stigma and underlying perceptions of lung cancer as a self-inflicted condition are also important considerations. 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. While consistent quality and safety of screening must be ensured across all screening centers, system factors are also important. 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. Research findings were mapped against a health systems framework adapted for lung cancer screening. 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. Using a health systems approach, this article evaluates key factors needed to enable the successful implementation of screening programs across Europe. However, to date, Poland, Croatia, Italy, and Romania are the only European countries to commit to large-scale implementation of targeted LDCT screening. 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. Lung cancer is the leading cause of cancer death in Europe.
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