Portugal’s Slow Rollout of Lung Cancer Screening Raises Expats’ Concerns

Settling in Portugal comes with enviable perks—mild winters, ocean views, strong public healthcare—but even the National Health Service (SNS) cannot sidestep one hard fact: lung cancer remains the country’s top cancer killer. While 2025 finally brought pilot screening projects to life, a comprehensive national programme is still on the drawing board, mired in politics and budget wrangling. Here is what newcomers should know.

Why lung-cancer screening matters for residents

Moving to Portugal does not erase lifestyle risks that followed you onto the plane. Lung cancer is responsible for roughly 12 deaths every day, and unlike breast or colorectal cancer, Portugal has no fully fledged screening system yet. For smokers and ex-smokers aged 55-74, the disease is often detected late, when treatment options shrink dramatically. International trials show a low-dose CT scan can cut mortality by about 20%, and Portuguese oncologists say early detection may boost five-year survival up to eight-fold. Even non-smokers exposed to urban pollution or second-hand smoke benefit from better diagnostic pathways. In short, the stakes are high for anyone holding a Número de Utente card.

Portugal’s slow march toward nationwide screening

Unlike the mammography vans that criss-cross the country, lung screening has inched forward only recently. Two high-profile pilots were authorised in 2025, one linked to the ULS de Santo António in Porto and another in coastal Cascais. Both aim to run for a full year before any verdict is given in 2027. Public-health planners deliberately chose contrasting geographies—Porto’s industrial north and the more affluent Lisbon suburb—to test logistics across socioeconomic lines. Yet critics note that Portugal first floated a national plan back in 2019, meaning six years of debate have produced just 2 pilot zones. That timeline compares poorly with breast-cancer screening, rolled out nationwide in under five years during the 1990s.

The pilots: Porto, Cascais and the islands

The northern project is housed in a refurbished wing next to Porto’s historic hospital, where a new generation of low-dose CT scanners will handle eligible patients flagged by family doctors. In Cascais, the local council is co-funding mobile units that can park near supermarkets—an idea borrowed from England’s Targeted Lung Health Checks. Meanwhile, the Azores are lining up a third initiative across São Miguel and Terceira, pending equipment deliveries to smaller islands such as Santa Maria and Flores. All three pilots use identical criteria: at least 20 pack-years of smoking, quit fewer than 10 years ago, no prior lung-cancer diagnosis, and consent to counselling on cessation programmes funded by the SNS.

Political and financial stumbling blocks

Pulmonale, the national lung-cancer charity, accuses successive governments of “falta de vontade política”—lack of political will. The group says Portugal even forfeited EU4Health funding in 2023 because no official commission existed to shepherd the paperwork. The Ministry of Health counters that the 2026 state budget will contain, for the first time, a dedicated € line item for prevention and screening, but insiders caution that radiology departments are already short of staff. Furthermore, without seamless data-sharing between family-health units and hospital surgeons, suspicious nodules may languish in queue. Radiologist shortages, uneven regional budgets, and red-tape around patient recruitment remain formidable hurdles.

How other European neighbours cracked the code

Across the Channel, the UK’s Targeted Lung Health Checks screened more than 120,000 people by parking CT vans outside Tesco and Morrisons. Croatia paired mobile scanners with counselling on quitting tobacco through the EU-funded SOLACE project, widening access in rural districts. Common threads include multidisciplinary teams, ring-fenced financing, and integration with primary-care records—features Portugal has partially emulated but not yet scaled. Health-policy academics argue that adopting AI triage tools, as Croatia did, could help Portugal cope with its radiologist gap.

What expats should watch for

Foreign residents registered with the SNS will be contacted automatically if they fit the risk profile, but you can also raise the issue during your next consulta with a médico de família. Private hospitals already offer low-dose CT scans for roughly €120–€180, yet insurance coverage varies. Even if you never smoked, Portugal’s high smoking prevalence—around 17% of adults still light up daily—means ambient exposure is real. Keep an eye on the 2026 budget debate; if lawmakers green-light nationwide screening, roll-out could start as early as 2028. Until then, the safest move is simple: quit, test when invited, and stay informed.