Free Lung CTs Coming to Portugal: What Long-Term Smokers Should Know

The Portuguese public health service is preparing to roll out its first ever lung-cancer screening programme, a move that could be life-saving for long-term smokers and the millions of expatriates who call the country home. Starting in early 2026, residents aged 55-74 with a heavy smoking history will be offered a low-dose chest CT in Porto or Cascais—at no cost if they are registered with the Serviço Nacional de Saúde (SNS). The pilot is small, but its implications are large: earlier detection, simpler treatment and potentially thousands of avoided deaths.

Why This Matters for Foreign Residents

Portugal’s oncology statistics rarely make international headlines, yet the country records 4 500 lung-cancer deaths a year, making the disease its deadliest tumour. Unlike in France, Germany or the UK—where organised national scans are already in place—Portugal is only now catching up. For foreigners who have accrued Portuguese residency rights, the pilot means free access to technology that many pay for privately elsewhere. It also offers a window into how the SNS works: once you are assigned a médico de família and confirm your address, you qualify for the same preventive checks as any Portuguese citizen. In an era where immunotherapy breakthroughs make early diagnosis more valuable than ever, the timing could not be better.

How the Pilot Works

The Directorate-General of Health has chosen two very different settings to test the waters. In the north, ULS de Santo António in Porto—a university-linked mega-hospital—will start scanning in the first quarter of 2026. Down south, the coastal municipality of Cascais has earmarked municipal funds to buy identical low-dose CT scanners before the end of 2025. Both sites will employ protocols modelled on the American NLST and the European NELSON trials, limiting radiation exposure to roughly one-quarter of a traditional CT. Every participant gets a base-line scan; if no suspicious nodules appear, they return once a year for follow-up. A positive result triggers a fast-track referral to pulmonology or thoracic surgery within 30 days.

Who Can Book a Scan

To be invited you must be between 55 and 74 years old, have smoked the equivalent of 20 pack-years—roughly one pack a day for 20 years—and, if you quit, have done so less than 10 years ago. Gender is irrelevant, although specialists note a sharp rise in female cases because Portuguese women took up smoking later than men. Foreigners qualify so long as they possess an SNS user number and are attached to a local centro de saúde. Expect to receive a digital summons via the SNS 24 app or a phone call from your family-health team. Those insured privately can still join, but the pilot’s data must feed into the national registry, so opting out of the public pathway is discouraged.

Balancing Benefits and Risks

Doctors here emphasise the upside: detecting tumours when they are under 3 centimetres can raise five-year survival beyond 90 %. International studies suggest lung-cancer mortality drops 20–25 % in screened cohorts. Yet the scan is not without drawbacks. Even at low doses, cumulative radiation is a factor if you enrol for multiple years. Roughly 1 in 5 scans produces a nodule that turns out to be harmless, exposing patients to anxiety and sometimes invasive biopsies. Portuguese societies of pneumology and radiology argue the trade-off is worth it but stress the need for clear counselling, particularly in a multicultural setting where language can blur risk perception.

What Happens After the Pilot

If Porto and Cascais hit their recruitment targets—about 18 000 people in the north and a few thousand on the coast—the Ministry of Health plans to extend screening nationwide by 2028. Next year’s state budget already reserves a new line for “promoção e prevenção”, signalling political commitment. A final go-ahead will depend on cost-effectiveness data: each scan is cheap by oncology standards (under €60), but follow-on tests add up. Public-health economists estimate that avoiding a single late-stage case saves the system €40 000 in chemotherapy costs alone.

Navigating the Portuguese Health System

If you are new to Portugal, register for an SNS number at your local junta de freguesia or loja do cidadão. Bring proof of address and residency documents; EU citizens can use a certificate of registration, while non-EU residents show a valid residence permit. Once assigned a family doctor, ask to have your smoking history logged. When the pilot opens, eligibility lists will be pulled directly from electronic records, so making sure your file notes a 20 pack-year history could be the difference between an invitation and radio silence. For those preferring the private route, Lisbon’s large hospital groups charge €75–€120 for low-dose CTs, and most international insurance policies reimburse the fee if ordered by a physician. Either way, catching potential tumours before they spread beats learning Portuguese medical terminology the hard way.