{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:27:42Z","timestamp":1785414462910,"version":"3.56.0"},"reference-count":301,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","award":["the SOLACE project, co-funded by the European Union under the EU4Health Programme 2021\u20132027, grant agreement No. 101101187"],"award-info":[{"award-number":["the SOLACE project, co-funded by the European Union under the EU4Health Programme 2021\u20132027, grant agreement No. 101101187"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"award":["the SOLACE project, co-funded by the European Union under the EU4Health Programme 2021\u20132027, grant agreement No. 101101187"],"award-info":[{"award-number":["the SOLACE project, co-funded by the European Union under the EU4Health Programme 2021\u20132027, grant agreement No. 101101187"]}],"id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background\/Objectives: Lung cancer remains the leading cause of cancer-related mortality in Central and Eastern Europe (CEE), where late-stage diagnosis, structural healthcare limitations, and regional epidemiological confounders complicate early detection. This review aimed to synthesize the evidence from Romania, Poland, Hungary, and Bulgaria and to outline a context-adapted multimodal screening strategy for CEE settings. Methods: A structured review of PubMed-, Scopus-, and Web of Science-indexed literature published from 2010 through 27 December 2025 was performed, focusing on lung cancer epidemiology, screening, implementation barriers, risk stratification, and adjunctive diagnostic approaches in the four selected CEE countries. A total of 297 articles were included. Results: The evidence confirms a persistently high burden of late-stage lung cancer across CEE, driven by tobacco exposure, air pollution, radon, comorbidities, diagnostic delays, fragmented registries, workforce shortages, and marked socioeconomic and geographic inequalities. In addition, tuberculosis-related granulomatous lesions and chronic inflammatory lung disease complicate nodule interpretation and reduce screening specificity in parts of the region. Screening experience from Poland and Hungary supports the feasibility of low-dose computed tomography (LDCT) when paired with volumetric assessment and structured follow-up. Risk-prediction models may improve participant selection, while biological triage may help reduce unnecessary invasive procedures, although prospective validation remains limited. Conclusions: In CEE, lung cancer screening should be implemented as a multimodal, context-adapted program combining risk-based enrollment, volumetric LDCT, selective biological triage, smoking-cessation support, and centralized multidisciplinary delivery.<\/jats:p>","DOI":"10.3390\/medsci14020259","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T12:36:40Z","timestamp":1779107800000},"page":"259","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond the Scan: Adapting Multimodal Lung Cancer Screening for Central and Eastern Europe\u2014Overcoming Systemic Barriers and Epidemiological Confounders"],"prefix":"10.3390","volume":"14","author":[{"given":"Rodica","family":"Anghel","sequence":"first","affiliation":[{"name":"Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Street, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3350-7850","authenticated-orcid":false,"given":"Antonia-Ruxandra","family":"Folea","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Street, 050474 Bucharest, Romania"},{"name":"Oncological Institute \u201cAlexandru Trestioreanu\u201d Bucharest, 252 Soseaua Fundeni, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad-Luca","family":"Moga","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Street, 050474 Bucharest, Romania"},{"name":"Oncological Institute \u201cAlexandru Trestioreanu\u201d Bucharest, 252 Soseaua Fundeni, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Pavel","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Street, 050474 Bucharest, Romania"},{"name":"Oncological Institute \u201cAlexandru Trestioreanu\u201d Bucharest, 252 Soseaua Fundeni, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Troncot\u0103","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Street, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matei","family":"Celea","sequence":"additional","affiliation":[{"name":"Oncological Institute \u201cAlexandru Trestioreanu\u201d Bucharest, 252 Soseaua Fundeni, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corneliu-Octavian","family":"Dumitru","sequence":"additional","affiliation":[{"name":"Remote Sensing Technology Institute, German Aerospace Center, M\u00fcnchener Str. 20, 82234 Wessling, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea-Iren","family":"\u0218erban","sequence":"additional","affiliation":[{"name":"Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agronomic Sciences and Veterinary Medicine, 105 Splaiul Independentei, 050097 Bucharest, Romania"},{"name":"Faculty of Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liviu","family":"B\u00eelteanu","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Street, 050474 Bucharest, Romania"},{"name":"Faculty of Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania"},{"name":"Laboratory for Molecular Nanotechnologies, National Institute for Research and Development in Microtechnologies\u2014IMT Bucharest, 126A, Erou Iancu Nicolae Street, 077190 Voluntari, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Smolarz, B., \u0141ukasiewicz, H., Samulak, D., Piekarska, E., Ko\u0142aci\u0144ski, R., Romanowicz, H., Smolarz, B., \u0141ukasiewicz, H., Samulak, D., and Piekarska, E. 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