Portugal Launches Pilot Lung Cancer Screening at Two Hospitals — Funded by Tobacco Tax

Portugal has launched its first organised lung cancer screening programme, with pilot projects now running at two National Health Service hospitals — ULS de Gaia/Espinho in the Porto metropolitan area and ULS de Santa Maria in Lisbon.

The initiative, formalised by Despacho n.º 4667/2026 published in the Diário da República on 9 April, entered into force on 10 April. It follows a November 2022 EU Council recommendation urging member states to develop population-based screening for lung cancer, the leading cause of cancer death in Portugal.

12 Deaths Per Day

The numbers behind the programme are stark. In 2023, lung cancer killed 4,490 people in Portugal — the highest figure in two decades, averaging 12 deaths per day, according to INE data. The Health Ministry described it as "the neoplasm that contributes most to the loss of healthy years of life in the Portuguese population."

In neighbouring Spain, lung cancer mortality among women has already surpassed breast cancer. Portuguese health officials say the trend is heading in the same direction.

Who Gets Screened

The programme targets adults aged 55 to 74 who are current smokers, ex-smokers who quit within the last 10 years, or those who quit within the last 20 years but had significant cumulative tobacco exposure — roughly equivalent to a pack a day.

Screening uses low-dose computed tomography (LDCT) scans, paired with structured diagnostic pathways and referrals to smoking cessation programmes.

At ULS Santo António in Porto, which is preparing to join the programme alongside Cascais, an estimated 93,000 people fall within the target age group, with roughly 18,000 considered at-risk smokers. Cascais expects to screen about 4,500 people per year using a mobile unit — an approach borrowed from COVID-19 testing.

"We learned from COVID-19 that we need to go to people at the neighbourhood level to achieve higher participation," said Cascais Mayor Carlos Carreiras, who hopes to reach 50 per cent adherence. He noted that breast cancer screening adherence in the municipality currently sits below 15 per cent.

Funded by Tobacco Tax

The pilot is financed through tobacco tax revenue. Since February 2026, two per cent of tobacco tax receipts have been earmarked for prevention and control policies, channelled through programme contracts between the SNS Executive Directorate, ACSS, and the participating health units.

Cascais has invested approximately EUR 2 million in screening equipment, including a dedicated mobile imaging unit. At ULS Santo António, a new imaging facility is being installed at Hospital Magalhães Lemos, with staff undergoing specialised training.

What Happens Next

The pilots are set to run for 12 months, with interim evaluations throughout. A final report must be submitted to the Minister of Health within three months of completion, including a proposal for possible expansion to a nationwide programme.

Additional pilot sites may be added by decree of the SNS Executive Director. The initiative is aligned with Portugal's National Cancer Strategy — Horizon 2030, which identifies organised screening as a strategic priority.

Sources: Diário da República (Despacho n.º 4667/2026), Observador, Notícias ao Minuto, ULS Santo António