CT Lung Screening Training Varies Across Europe

Training for low-dose computed tomography lung cancer screening differs widely across Europe and remains unevenly developed. A survey published in Insights into Imaging explored current practice and training needs through interviews with 25 experts from 14 European countries. Participants worked in radiology, pulmonology, thoracic surgery, general practice, smoking cessation and programme management. Every country represented had an active screening programme or pilot, but only a few had a formal training programme. The findings support the development of shared curricula that cover technical knowledge, communication and multidisciplinary working across the full screening pathway. 

Must Read: Lung Screening CT May Reveal Hidden Bone Loss 

Training Provision Remains Uneven 

Established lung cancer screening training programmes were reported in 4 of the 14 participating countries. These programmes mainly focused on radiologists, although some also included general practitioners, radiographers, nurses and pulmonologists. Only the United Kingdom and France reported mandatory training. Course formats varied. General practitioners often received short online sessions, while radiologists usually completed hybrid courses with practical teaching lasting several days. Assessment methods also differed. Most formal programmes required a final examination, but only half asked radiologists to meet a minimum annual volume of low-dose CT reading. 

Another four countries were planning programmes, mainly for radiologists and, in some cases, general practitioners and pulmonologists. Proposed formats included online and hybrid courses, as well as a virtual university-based master’s degree in Spain. Six countries reported less formal learning initiatives, again mostly aimed at radiologists. International voluntary certification was available, but respondents in only four countries mentioned it as an option. Two countries used internal quality checks based on activity levels or coordinator assessment. 

Screening teams were more diverse than the training programmes. Radiologists were involved in all core teams, pulmonologists in almost all and general practitioners in most. Thoracic surgeons, radiographers, smoking cessation specialists, programme coordinators and pathologists also took part, but their involvement varied. This gap between multidisciplinary practice and more limited training shows the need for education that covers the whole screening pathway. 

Curricula Must Cover More Than Imaging 

Experts identified radiologists, pulmonologists and general practitioners as the main groups needing dedicated training. Thoracic surgeons, programme coordinators, radiographers and smoking cessation specialists were also seen as important. Their roles span participant selection, counselling, image interpretation, nodule management, referral and follow-up, so training needs to reflect these different responsibilities. 

Management of incidental findings was rated as the most important area for improvement. Low-dose CT can show abnormalities beyond lung nodules, including findings linked to cardiovascular and respiratory disease. Professionals therefore need clear training on what to report, how to manage these findings and who is responsible for follow-up. Confident use of nodule management guidelines was another major priority. Other areas included structured reporting, communication, inclusion criteria, possible harms and teamwork. 

The highest-rated core skills were managing incidental findings and applying nodule management guidelines. Basic knowledge of artificial intelligence tools and effective communication with screening participants also ranked highly. Additional skills included technical knowledge of low-dose CT, use of structured reporting systems, multidisciplinary working, organisation, data handling and awareness of minimally invasive diagnostic techniques. 

Smoking cessation appeared several times in the responses. Screening was viewed as a chance to combine early cancer detection with support to reduce tobacco-related risk. Respondents therefore supported adding smoking cessation knowledge to training for professionals across the screening pathway rather than leaving it only to specialist staff. 

Residency Training Receives Broad Support 

Most respondents supported adding lung cancer screening education to residency training. Radiology received the strongest support, followed by pulmonology, thoracic surgery and general practice. Oncology was the most common additional specialty suggested. Most experts also supported involving residents in multidisciplinary team meetings, where they could learn how imaging, clinical assessment and follow-up decisions are combined. 

There was less agreement on when training should start or how long it should last. Some experts preferred the later years of residency, while others said timing was difficult to define because screening programmes and specialist training structures differ between countries. Only a few suggested a duration for a basic module, with estimates ranging from one week to two months. A small number also recommended introducing awareness during medical school or extending it to all medical specialties. 

Limited awareness of the need for dedicated training was rated as the main barrier. Lack of time and limited access to courses were considered less important. Additional comments pointed to weak professional incentives and limited institutional or political support. Respondents did not view the shortage of chest radiologists as a leading obstacle to creating structured programmes. 

The findings have limitations. The sample was small and included slightly more radiologists than other professional groups. Participation from Northern and Eastern Europe was limited. Recruitment relied partly on professional networks, and the responses reflected expert opinion rather than direct measures of training quality. These factors reduce how widely the findings can be applied. 

Lung cancer screening education remains inconsistent across the European countries represented, with clear differences in course content, target groups, assessment and certification. Shared core curricula and minimum standards could provide a more consistent base while still allowing national adaptation. Priority areas include incidental findings, nodule management, basic knowledge of artificial intelligence, communication and smoking cessation. Residency education and multidisciplinary team involvement also received strong support. Future training should reflect the full screening pathway and prepare all relevant professionals to work together within organised lung cancer screening programmes. 

Source: Insights into Imaging