Previous Article in Journal
Urinary Biomarkers in Parkinson’s Disease: A Structured Integrative Review of Pathophysiological Pathways
Previous Article in Special Issue
Loss of PTEN as an Independent Poor Prognosis Indicator in Lung Adenocarcinoma, but Not in Squamous Cell Carcinoma, Is Associated with an Immunosuppressive Tumor Microenvironment and Distinct Co-Mutational Profiles
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Medical Sciences
Volume 14
Issue 2
10.3390/medsci14020259
medsci-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Beyond the Scan: Adapting Multimodal Lung Cancer Screening for Central and Eastern Europe—Overcoming Systemic Barriers and Epidemiological Confounders

by
Rodica Anghel
1,
Antonia-Ruxandra Folea
1,2,*,
Vlad-Luca Moga
1,2,
Cristian Pavel
1,2,
Diana Troncotă
1,
Matei Celea
2,
Corneliu-Octavian Dumitru
3,
Andreea-Iren Șerban
4,5 and
Liviu Bîlteanu
1,5,6
1
Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Street, 050474 Bucharest, Romania
2
Oncological Institute “Alexandru Trestioreanu” Bucharest, 252 Soseaua Fundeni, 022328 Bucharest, Romania
3
Remote Sensing Technology Institute, German Aerospace Center, Münchener Str. 20, 82234 Wessling, Germany
4
Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agronomic Sciences and Veterinary Medicine, 105 Splaiul Independentei, 050097 Bucharest, Romania
5
Faculty of Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania
6
Laboratory for Molecular Nanotechnologies, National Institute for Research and Development in Microtechnologies—IMT Bucharest, 126A, Erou Iancu Nicolae Street, 077190 Voluntari, Romania
*
Author to whom correspondence should be addressed.
Med. Sci. 2026, 14(2), 259; https://doi.org/10.3390/medsci14020259
Submission received: 25 March 2026 / Revised: 6 May 2026 / Accepted: 14 May 2026 / Published: 18 May 2026
(This article belongs to the Special Issue Feature Papers in Section “Cancer and Cancer-Related Research”)
Versions Notes

Abstract

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.
Keywords: low-dose computed tomography; lung cancer screening; structural barriers; Central and Eastern Europe low-dose computed tomography; lung cancer screening; structural barriers; Central and Eastern Europe

Share and Cite

MDPI and ACS Style

Anghel, R.; Folea, A.-R.; Moga, V.-L.; Pavel, C.; Troncotă, D.; Celea, M.; Dumitru, C.-O.; Șerban, A.-I.; Bîlteanu, L. Beyond the Scan: Adapting Multimodal Lung Cancer Screening for Central and Eastern Europe—Overcoming Systemic Barriers and Epidemiological Confounders. Med. Sci. 2026, 14, 259. https://doi.org/10.3390/medsci14020259

AMA Style

Anghel R, Folea A-R, Moga V-L, Pavel C, Troncotă D, Celea M, Dumitru C-O, Șerban A-I, Bîlteanu L. Beyond the Scan: Adapting Multimodal Lung Cancer Screening for Central and Eastern Europe—Overcoming Systemic Barriers and Epidemiological Confounders. Medical Sciences. 2026; 14(2):259. https://doi.org/10.3390/medsci14020259

Chicago/Turabian Style

Anghel, Rodica, Antonia-Ruxandra Folea, Vlad-Luca Moga, Cristian Pavel, Diana Troncotă, Matei Celea, Corneliu-Octavian Dumitru, Andreea-Iren Șerban, and Liviu Bîlteanu. 2026. "Beyond the Scan: Adapting Multimodal Lung Cancer Screening for Central and Eastern Europe—Overcoming Systemic Barriers and Epidemiological Confounders" Medical Sciences 14, no. 2: 259. https://doi.org/10.3390/medsci14020259

APA Style

Anghel, R., Folea, A.-R., Moga, V.-L., Pavel, C., Troncotă, D., Celea, M., Dumitru, C.-O., Șerban, A.-I., & Bîlteanu, L. (2026). Beyond the Scan: Adapting Multimodal Lung Cancer Screening for Central and Eastern Europe—Overcoming Systemic Barriers and Epidemiological Confounders. Medical Sciences, 14(2), 259. https://doi.org/10.3390/medsci14020259

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop