World Lung Cancer Day: how the SOLACE project is increasing lung cancer screening to reduce mortality

On the occasion of World Lung Cancer Day, HaDEA interviewed Dr. Anna Kerpel-Fronius and Prof. Joanna Chorostowska-Wynimko, co-scientific coordinators of the EU-funded SOLACE project. Together, they represent radiology and pulmonology, two medical specialties that are essential for delivering successful lung cancer screening in real-world settings. 

1. What is the focus of the SOLACE project? 

Earlier research, including the National Lung Screening Trial in the United States and the NELSON trial in Europe, has shown that screening high-risk individuals¹ with low-dose computed tomography scans can detect lung cancer much earlier than when patients present with symptoms. This kind of screening in individuals such as current or former heavy smokers over the age of 50 allows for more effective treatment because it can catch the disease in its earliest stages, which improves patient outcome. Screening can also reduce long-term costs to healthcare systems compared to treating advanced cancer. 

SOLACE (Strengthening the screening of Lung Cancer in Europe) is a project co-funded by the EU4Health programme to expand and improve lung cancer screening across the continent. The project includes 37 partners across 15 EU countries, with sites in 12 countries running implementation pilots: Croatia, Czechia, Estonia, France, Germany, Greece, Hungary, Ireland, Italy, the Netherlands, Poland and Spain. The project is inspired and strongly supported by two major medical societies: European Respiratory Society (ERS) and European Society of Radiology (ESR). 

Outcomes and conclusions from the SOLACE pilots will feed into the development of  evidence-based guidelines to support the implementation of screening programmes in the EU and the wider adoption of these approaches. This will enable more lives to be saved and healthcare costs to be contained. 

^{1 For example, current or former smokers of 20 pack years or more over the age of 50 years. A pack year is used to quantify a person’s lifetime cigarette smoking, and it is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked.}

2. Could you tell us more about these pilot projects? 

Three pilots across the 12 countries involved in SOLACE have provided particularly valuable insights. 

Pilot 1 has focused on increasing participation among women, who have often been underrepresented in screening trials despite rising rates of lung cancer. Countries such as France, Greece, Ireland and others have tested ways to raise awareness among women at higher risk so that those who are eligible understand how screening works and what benefits it offers. These pilots have also explored different strategies to encourage attendance, moving beyond general information to more active engagement. For example, combining breast and lung cancer checks has helped to normalise screening and made it more convenient for patients to take part. 

Pilot 2 has targeted groups that are often considered hard to reach, including people who may face socioeconomic disadvantage, cultural or language barriers, or who live in remote areas where access to care is more limited. In Croatia, Poland, Hungary and other countries, community outreach and tailored communication have been essential to building trust and increasing uptake. This has included working with local health professionals, such as family doctors and nurses, as well as deploying mobile screening units to bring services closer to people’s homes, reducing the need for travel and time spent in unfamiliar clinical settings. 

Pilot 3 has concentrated on engaging people with existing health conditions and offering screening to individuals who are at higher risk because they live with chronic respiratory diseases, such as chronic obstructive pulmonary disease or interstitial lung disease. In countries including Czechia, Germany and Spain, SOLACE pilots have supported targeted outreach to these groups and worked to integrate screening into the care pathways they already use, so that participation feels more familiar and accessible. 

3. What comes next after the pilots? 

All the work that is being performed in SOLACE will continue through the European Lung Cancer Screening Alliance, which brings together clinical experts, policymakers, and patient organisations to share knowledge and develop evidence-based strategies. 

The alliance aims to improve participation, reduce inequalities and help establish effective lung cancer screening across Europe by integrating lessons learned from each country’s experience into programme design and implementation. 

4. Are there any significant challenges the project has faced or expects to face? 

Yes, several challenges have arisen during implementation. Even within Europe, there is significant diversity in healthcare provision, technical readiness and public awareness of lung cancer screening and its potential benefits. As a result, SOLACE activities have had to be tailored to each country’s needs and realities. 

In some countries, recruitment is mainly led by general practitioners who personally refer patients. In others, invitations are issued by specialist centres or regional health authorities or combined with other screening programmes to integrate lung checks more efficiently. Some of these approaches have proven more effective in certain settings than in others, which highlights the importance of testing different strategies and adapting programmes to local circumstances. 

The capacity of radiology services has been another challenge. Large-scale screening generates high volumes of low-dose computed tomography scans, and there is an ongoing need for modern equipment and radiologists with the necessary training. SOLACE has been assessing how artificial intelligence can help interpret scans and manage workloads. This does not mean AI will replace clinical judgement. Instead, it can be a tool to support radiologists, improve efficiency and shorten waiting times for patients who may feel anxious about their results. 

Finally, securing sustainable funding is essential to ensure screening remains available to all eligible individuals. While EU support helps launch and coordinate the project, long-term resources at the national level will be necessary to maintain and expand services. 

5. How important has the support of EU funding been for your project? 

EU funding has been vital. Coordinating a project of this complexity and scale across 15 countries requires substantial resources for management, technical infrastructure, communication and data analysis. A strong coordination team and back-office support are critical to guide partners and maintain consistency. 

Without EU backing, it would be very difficult to deliver this project. This collaboration is exactly what is needed to generate reliable evidence for designing and implementing high-quality lung cancer screening. We hope to continue this work and use what we learn to strengthen screening programmes across Europe and beyond. In doing so, we aim to save more lives, help people stay healthy for longer, and reduce the costs and challenges of treating cancer diagnosed at a late stage. 

Background 

SOLACE is funded under EU4Health and will run until 31 March 2026.  

EU4Health is the fourth and largest of the EU health programmes. The EU4Health programme goes beyond an ambitious response to the COVID-19 crisis to address the resilience of European healthcare systems. The programme provides funding to national authorities, health organisations and other bodies through grants and public procurement, contributing to a healthier Europe. HaDEA manages the vast majority of the total EU4Health budget and implements the programme by managing calls for proposals and calls for tenders.