PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

42 Acting early on NCDs The Partnership for Health System Sustainability and ResilienceFigure 14: Cancer screening (percentage of those in specified age range), 2019 and 2022 Notes: Breast cancer screening in past two years among women aged 50–69; Cervical cancer screening in past three years among women aged 20–69; Colorectal cancer screening in people aged 50–74 within the past two years. Source: OECD, 2024. Despite universal access to modern screening technology, coverage rates reveal dramatic disparities in programme reach. Spain achieved 70% cervical screening coverage of eligible women in 2022, well above the OECD average of 53%, while Poland reached only 15.7% – among the lowest rates in Europe (OECD, 2023a). The more than four-fold difference between Spain and Poland’s coverage rates demonstrates the importance of programme and accessibility. Colorectal cancer screening implementation varies from comprehensive to fragmentary. Canada reported a 59.2% screening rate in 2022 (MHLW, 2024e), while the report on Italy shows dramatic regional differences – from 62% in Veneto to just 4.4% in Calabria, a 14-fold variation within a single country. This regional disparity, exceeding differences between countries, reveals how implementation capacity matters more than programme existence. In 2022, France achieved 34.3% coverage despite organised programmes, suggesting persistent barriers to participation (WHO, 2024b). Lung cancer screening remains less developed, reflecting both its relative newness and implementation complexity. Only Canada (in six provinces) and Japan (45.0% coverage) have established programmes (MHLW, 2024e). Italy has implemented a successful pilot screening programme in Tuscany, whilst screening in Spain has not yet met criteria for national implementation resulting in disparities in rates. Poland’s COPD screening programme includes chest imaging but doesn’t specifically target lung cancer. Greece lacks any lung cancer screening initiative despite its long-standing high smoking rates. The limited implementation reflects multiple 49.4 49.9 60.7 81.5 59.7 65.7 44.6 37.2France Germany Italy Spain Canada Greece Japan Poland 2022 2019 73.4 77.9 38.5 70.0 59.1 72.9 43.7 15.730.4 43.8 40.5 21.8 59.2 27.6 44.2Breast cancer Cervical cancer Colorectal cancer