Lung Cancer, Policy Dialogue

Results and Consensus of the Policy Dialogue on Lung Cancer, Athens

Lung cancer remains one of the most lethal cancers, largely because it is often diagnosed at an advanced stage when curative treatment is no longer viable. In Greece, as in much of Europe, significant progress has been made in access to treatments; however, challenges persist in early detection, timely access to care, and equitable access to innovation.

This year’s Athens Policy Dialogue on Lung Cancer, convened by the Hellenic Cancer Federation ELLOK and the European Project ECHoS, with the support of the European Observatory on Health Systems and Policies brought together national and international experts, policymakers, healthcare professionals, pharma industry representatives, patient and citizen organisations, and public health leaders in Athens for a Policy Dialogue on Lung Cancer.

The event focused on strengthening prevention, improving early detection, ensuring equitable access to innovation, and tackling lung cancer across different stages of the disease while building a sustainable health system that delivers better outcomes.

Background

It is important to recognize that lung cancer is not a “self-inflicted” disease and can affect anyone. Addressing it effectively requires moving beyond stigma and focusing on prevention, early diagnosis, and quality care for all. Major risk factors (including smoking, vaping, air pollution, and occupational exposure) significantly increase the likelihood of lung cancer. Tobacco use remains the leading cause of preventable deaths in the EU, accounting for nearly 500,000 fatalities in 2021 and an estimated 2.5% of Europe’s annual GDP.

A Call for Bold, Coordinated Action

“Prevention is the first and most powerful pillar of a national lung cancer response,” participants emphasized during the event. Measures such as reducing smoking and vaping, improving air quality, and protecting workers from carcinogen exposure will save lives, strengthen health systems and benefit the economy.

Implementing a population-based screening programme will allow detection at earlier stages of the disease, with the potential to dramatically improve survival rates. Participants also emphasised that primary healthcare must be the cornerstone of a sustainable cancer strategy, serving as the main entry point for prevention, risk assessment, screening referrals and smoking/vaping cessation support.

Achieving truly integrated and patient-centred lung cancer care requires more than optimised clinical pathways; it depends on the underlying healthcare system’s capacity to support and sustain these improvements. Robust infrastructure, interoperable health data systems, standard operating procedures, workforce staffing levels and training, as well as policy frameworks, are all essential to enable consistent, high-quality care across regions. By strengthening these system-level enablers, Greece can ensure that innovations in prevention, diagnosis and treatment are translated into tangible benefits for patients.

Participants highlighted that preventable mortality will continue until all patients can access innovation as early as possible, from diagnosis onwards -including molecular diagnostics, tumour profiling, and cutting-edge treatments. Eligibility tools, such as the ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT), should be used to define relevant criteria and guide decision-making. These steps would ensure that each patient rapidly receives the most effective and least invasive therapy available.

Effective lung cancer care extends beyond diagnosis and treatment to help patients and their families reintegrate into daily life, work and society. Supportive care and survivorship programmes should be set up in Greece to provide comprehensive support, including physical and pulmonary rehabilitation, psychological counselling, vocational guidance and social services.

By addressing the long-term needs of patients with lung cancer and survivors, Greece can improve their quality of life, access to social support, reduce the burden on families and the healthcare system, and ensure that survivors remain engaged and empowered in their ongoing care.

Key Recommendations

1. Prevention and Public Awareness

  • Fully implement the WHO FCTC (Framework Convention on Tobacco Control) measures and Hellenic Law 5216/2025 to protect minors and reduce tobacco use.
  • Launch nationwide campaigns to raise awareness about smoking, vaping, and lung cancer risk, promoting cessation support and destigmatising the disease. Where possible, these campaigns should collaborate with other public health initiatives, such as cardiovascular health programmes, to maximise resources and impact.
  • Address air pollution and occupational exposures through evidence-based regulation and enforcement.
  • Encourage healthy lifestyle choices from an early age, including targeted school-based and workplace programmes.

2. Primary Care and Early Detection

  • Empower General Practitioners as the first line of defence: identify individuals at risk, provide balanced information on screening, encourage cessation, and refer promptly.
  • Implement risk-based low-dose CT screening for lung cancer as the fourth national cancer screening pillar in Greece, following guidance by EU/WHO and by the Hellenic National Task Force on Lung Cancer Screening, a multidisciplinary Task Force where ELLOK is a key partner. The Task Force has established national guidelines on lung cancer screening, standard operating procedures tailored to the Hellenic National Health System, a quality assurance scheme as per European guidance, and a dedicated lung cancer screening training curriculum for healthcare professionals, and it has therefore provided a pragmatic implementation framework.
  • Ensure outreach to rural, low-income and underserved populations (where smoking prevalence is higher) and raise public awareness of early symptoms and screening availability.

3. Equitable, Integrated Care Pathways

  • Improve early access to cutting-edge innovative therapies.
  • Create structured diagnostic and treatment patient pathways for lung cancer in Greece. This will streamline the provision of care across the spectrum of lung cancer and will ensure improved patient outcomes and more efficient use of healthcare resources.
  • Guarantee timely access to the diagnostic and treatment pathway for lung cancer, including molecular diagnostics and precision oncology using validated frameworks.
  • Ensure patients with lung cancer have access to strengthened multidisciplinary (MDT) care, including respiratory physicians, oncologists, radiotherapists, radiologists, thoracic surgeons, clinical nurse specialists, pathologists, psycho-oncologists and patient representatives.
  • Ensure patients’ access to clinical trials for novel therapies.
  • Integrate supportive care from diagnosis to treatment and beyond, ensuring holistic care for patients and families.
  • Assess patients’ social, financial and spiritual needs, where applicable and suggest guidance for the provision of dedicated support should this be required.
  • Link smoking and vaping cessation programmes to both prevention and treatment pathways.
  • Promote inter-specialty training for healthcare professionals, including nurses, surgeons, pathologists and psycho-oncologists, to enhance coordination and quality of care.

4. Patient Navigation and Support

  • Establish a Patient Navigator role for newly diagnosed patients to serve as a single point of contact, coordinating diagnostics, appointments and MDT referrals, providing psychosocial support and guiding patients to clinical trials and rehabilitation services.
  • Integrate survivorship programmes, including vocational and psychological support into the National Cancer Control Plan.

5. System-Level Enablers

  • Develop, expand and modernise cancer registries and introduce quality indicators to monitor outcomes and equity.
  • Expand the existing digital prevention platform to include a fourth pillar on lung cancer screening.
  • Harness self-assessment tools, invest in digital health infrastructure, telehealth and patient digital literacy.
  • Establish a National Lung Cancer Task Force under the Ministry of Health to oversee implementation, liaise with European partners and track measurable progress.
  • Empower patient organisations through co-created decision tools and participation.
  • Actively monitor the quality of care and implement quality assurance schemes as per European guidance. Centres should establish performance metrics and quality indicators in line with the European Cancer Organisation’s Essential Requirements for Quality Cancer Care: Lung Cancer and other relevant guidelines, while complying with national and legal standards.
  • Implement effective operational policies to realise the full benefits of a coordinated clinical pathway. This includes robust data management and reporting, active engagement with patients, carers and support organisations and clear governance and accountability mechanisms.
  • Launch pilot projects to test innovative approaches in prevention, screening, or care delivery before wider rollout.
Economic and Societal Impact

Participants highlighted that earlier detection, timely treatment and coordinated care can reduce health system costs, improve workforce productivity and deliver measurable survival gains. “Every year of delay, costs lives and strains hospitals, action now will pay dividends for decades,” concluded one expert.

Call to Action
  • Combine anti-tobacco awareness, smoking and vaping cessation, and informative campaigns in schools, training institutions, universities, and targeted populations.
  • Invest in prevention, primary care, and innovation access to build a resilient, future-ready health system.
  • Establish a National Lung Cancer Screening Programme based on guidance published by the National Hellenic Task Force on lung cancer screening, by starting pilots that will feed information to a future national programme, optimising implementation and impact.
  • Empower patients and professionals alike through navigation support, education, and co-creation of solutions.
  • Facilitate earlier access to cutting-edge therapies and personalised medicine, and develop more lung cancer-focused clinical trials.
  • Design effective supportive care and survivorship programmes.
  • Align with EU Cancer Mission objectives and WHO targets to improve early detection, reduce mortality and deliver equitable access to innovation.

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