Data Sheet 1_From aspiration to reality: a cross-country analysis of the implementation of lung cancer screening in Europe.docx

BackgroundImplementation of lung cancer screening (LCS) has been slow across geographical Europe. Only three countries have a formal LCS program: Croatia, Poland, and England.
ObjectiveThis study aims to review the status of LCS and identify the barriers to implementation of formal programs.
MethodsA framework to assess the status and identify key gaps was used, consisting of five dimensions: (1) policy prioritization and governance, (2) clinical review, (3) program design, (4) implementation, and (5) awareness. The research was conducted in 10 countries including Belgium, Croatia, England, France, Germany, Greece, Italy, Poland, Spain, and Sweden. Across countries, the assessment framework was applied to identify key barriers. The assessment was validated with local experts.
ResultsCountries are at different stages of implementation, with large variability in the proposed program design. The cross-country analysis found common barriers. A crucial driver of stimulating political commitment is a local network of well-connected clinicians and patients. Although governments request local data to support decision making, in many countries, local data collection is minimal or stalled. Implementation is the most underdeveloped dimension in the framework, commitment to sufficient funding and infrastructure for scaling up pilots and post screening care delivery is a common barrier. Finally, awareness amongst the public and healthcare professionals requires improvement.
ConclusionProgress depends on a number of factors namely, political will, funding commitment, a local network of well-connected experts, availability of local evidence, and feasibility assessments.

背景 欧洲全域范围内肺癌筛查（Lung Cancer Screening, LCS）的实施推进始终迟缓。目前仅有克罗地亚、波兰与英格兰三个国家设有正式的肺癌筛查项目。
研究目的 本研究旨在梳理肺癌筛查的开展现状，并明确正式项目落地过程中的阻碍因素。
研究方法 本研究采用一套用于评估现状并识别关键缺口的分析框架，该框架包含五大维度：(1) 政策优先级与治理，(2) 临床评审，(3) 项目设计，(4) 项目实施，(5) 认知度。研究覆盖比利时、克罗地亚、英格兰、法国、德国、希腊、意大利、波兰、西班牙及瑞典共10个国家，通过在各国应用该评估框架以识别核心阻碍因素，并邀请当地专家对评估结果进行效度验证。
研究结果 各国肺癌筛查项目的实施阶段各不相同，拟议的项目设计存在显著差异。跨国分析识别出多项共通阻碍因素：搭建沟通紧密的临床医师与患者本地网络，是推动政治层面承诺落地的关键动因；尽管各国政府均呼吁依托本地数据支撑决策，但多数国家的本地数据采集工作仍处于极低水平或停滞状态；实施维度是该框架中最不完善的部分，为扩大试点规模及提供筛查后照护所需的充足资金与基础设施投入承诺，是普遍存在的阻碍；最后，公众与医疗专业人员的肺癌筛查认知水平仍有待提升。
研究结论 肺癌筛查项目的推进进展取决于多项核心要素，包括政治意愿、资金投入承诺、沟通紧密的本地专家网络、本地证据储备以及可行性评估工作。