Acting Early on Non-Communicable Diseases 2026

For non-cancer NCDs, systematic screening remains underdeveloped. Despite the availability of simple, low-cost tests and clear disease burden evidence, screening lags. Chronic kidney disease affects 10–15% of adults but lacks organized screening, with France reporting 25% of patients beginning haemodialysis in emergency situations,37 an outcome indicating systematic absence of mechanisms identifying declining kidney function before crisis occurs. Among PHSSR countries, only Japan’s Specific Health Check-Ups (SHCs) includes urinalysis as standard, though they are notably lacking the estimated glomerular filtration rate (eGFR) testing that would identify additional cases. Poland recently integrated kidney function assessment into its national preventive programme, though coverage remains uncertain given the historically low uptake of available screening. Beyond underuse, screening programmes remain fragmented despite obvious opportunities for integration. Poland’s COPD screening includes chest imaging but does not systematically screen for lung cancer, missing the opportunity to detect both conditions in high-risk populations through a single imaging modality. Recent international commitments – including the 2025 World Health Assembly resolution on lung health38 and the UN High-Level Meeting political declaration39 – emphasize integrated approaches for lung health, but implementation lags behind. Similarly, while cardiovascular disease, kidney disease and metabolic conditions share common risk factors and pathophysiology, screening remains siloed by condition. Recent guidelines recommend integrated screening approaches, recognizing that simultaneous assessment improves early detection and enables comprehensive risk stratification.40 The gap between programme availability and population participation reveals deeper barriers. Poland’s transition from “Prevention 40 PLUS” (20% uptake despite extensive promotion) to the expanded “My Health” programme illustrates the challenge: broadening eligibility without addressing participation barriers may simply extend non- participation.41 Japan’s SHCs achieved only 58.1% participation despite universal coverage and no financial barriers,42 while Germany’s cardiovascular screening reaches just 24% annually despite full insurance coverage.43,44 These patterns across diverse systems demonstrate that engagement requires addressing time constraints, health literacy, trust and perceived relevance – factors policy frameworks rarely consider. –Implement systematic risk stratification: Use validated tools such as SCORE2,45 moving beyond age-based criteria to incorporate multiple factors influencing disease probability. Improve systematic recording of social determinants within electronic health records, which current systems typically ignore despite their profound influence on disease development. –Integrate screening with risk factor management: Systematically link early detection to interventions addressing modifiable risks. Ensure cardiovascular and metabolic screening connects directly to stopping smoking, nutritional counselling and support for physical activity. Integrate stopping smoking within lung cancer screening pathways. –Expand screening programmes with explicit, mandatory equity targets: Implement opt- out enrolment with proactive recall, mobile screening units for rural areas and flexible scheduling. Systematically evaluate why eligible populations do not participate and invest in targeted awareness campaigns, simplified pathways and community engagement. –Strengthen primary care as the foundation for opportunistic detection: Expand authority to independently diagnose and initiate treatment for common NCDs such as diabetes, hypertension and COPD. Primary care providers should systematically review and optimize treatment and care plans. –Invest in diagnostic capacity by ensuring access to essential tools: Use spirometry for respiratory disease, computed tomography (CT)/magnetic resonance imaging (MRI) scanning and endoscopy for cancer detection, electrocardiogram (ECG) for cardiovascular conditions and point-of-care testing for diabetes and kidney disease. –Ensure sustainable financing: Provide dedicated, long-term funding integrated into regular health budgets rather than temporary sources, covering the full pathway from screening through diagnostic confirmation to treatment initiation.Policy levers Acting Early on Non-Communicable Diseases: A Framework for Health System Transformation 11