European Cancer Prevention Organization on cancer screening: an expert panel position paper

Background: Cancer screening is a cornerstone of cancer control in Europe yet marked disparities persist in access, implementation, and quality assurance among national or regional programs. Building on the EU Council's 2022 recommendations and the European Union's Beating Cancer Plan, the European Consensus Project (ECP) was established to provide harmonized, evidence-based recommendations for major cancer screening programs and to promote a shift toward risk-adapted, technology-enabled, and equitable prevention models. Methods: A structured expert panel meeting was convened under the auspices of the European Cancer Prevention Organization, integrating systematic literature review and multidisciplinary discussion to formulate validated, evidence-based recommendations. For each primary cancer site (breast, lung, colo-rectum, cervix, prostate, and stomach), systematic literature reviews identified evidence on reductions in mortality, stage distribution, participation, cost-effectiveness, and organizational quality. Results: The consensus reaffirmed the evidence of mortality reduction with organized breast, lung, colorectal, and cervical screening, endorsed structured risk-adapted prostate-specific antigen testing for prostate cancer, and recommended Helicobacter pylori 'screen-and-treat' strategies for gastric cancer in high-incidence regions. Insights into future perspectives of liquid biopsy approaches are outlined. Conclusion: The ECP Consensus outlines a European roadmap for precision screening, grounded in quality assurance, individual risk stratification, artificial intelligence integration, and public health literacy. These recommendations align with the EU Mission on Cancer and Europe's Beating Cancer Plan, providing a harmonized roadmap toward precision prevention and equitable implementation of screening across Europe.