The measure initiates two projects in these units and may extend to other SNS health establishments if the SNS executive director orders it.

The decree allows organisations to form partnerships or collaboration mechanisms with other private or public entities, such as municipalities, according to Lusa news agency, which had access to the decree and reports it should be published today in the Official Gazette.

The pilot projects are governed by terms of reference drawn up by the Directorate-General of Health (DGS). These terms include eligibility criteria, strategies for identifying the target population, and the time horizon. They also set protocols for screening, confirmatory diagnosis, and monitoring of the clinical response. Additionally, they outline quality and safety requirements, as well as referral pathways for smoking cessation programs.

According to the order, funding for the pilot projects is provided by the Central Administration of the Health System (ACSS). This funding is derived from tobacco tax revenue. Two per cent of this revenue is allocated to tobacco prevention and control policies. The funds are specifically integrated into program contracts between the Executive Directorate of the National Health Service (DE-SNS) and the health establishments where the projects take place.

The National Health Service Executive Board (DE-SNS) coordinates and monitors the screening programs. Local Health Units (LHS) run and execute the pilot projects. Their tasks include organising care pathways and allocating human and technical resources. They must coordinate between levels of care. They also ensure compliance with the terms of reference and reporting set by the Directorate-General of Health (DGS).

The DGS, with the Executive Board, ensures the clinical, epidemiological, and organisational evaluation of pilot projects. It also prepares a final report. The DE-SNS verifies the execution of the annual program to close accounts for the relevant program contracts.

The final evaluation report must be submitted to the Minister of Health within a maximum of three months after the end of the 12-month implementation period in the aforementioned Local Health Units (ULS), including a proposal for possible expansion or implementation at the national level.

The Ministry of Health emphasises that lung cancer is the leading cause of death from cancer and is strongly associated with tobacco use. Early diagnosis is crucial for improving survival, reducing the burden of the disease, and avoiding unnecessary use of healthcare services.

"This is the neoplasm that contributes most to the loss of healthy years of life in the Portuguese population, highlighting the magnitude of its impact on public health," he emphasises.

The Government's initiative follows a recommendation from the Council of the European Union, which in November 2022 encouraged member states to move forward with pilot projects in this area.

In recent years, several European countries have been testing organised programs targeting higher-risk groups, with promising results in reducing mortality.

Despite this, there is still no international consensus on the ideal model for population screening, particularly regarding eligibility criteria, frequency, organisation of care pathways, or integration with smoking cessation programs.

The projects will follow guidelines defined by the DGS (Directorate-General of Health) based on the best available scientific evidence.

Among the measures planned are the use of low-dose computed tomography, defining eligibility criteria, creating structured care pathways, and coordinating with smoking cessation programs.