In 2024, the Estonian Health Insurance Fund completed a three-year-long research project in Tartu and Tartu County, whereby researchers from the University of Tartu, doctors from Tartu University Hospital and family doctors, piloted ways lung cancer screening could be conducted throughout Estonia.

After analyzing the results of that research, the Health Insurance Fund has decided to move forward with the nationwide expansion of lung cancer screening in Estonia.

Maria Suurna, the Health Insurance Fund's head of screening services, told ERR that lung cancer screening cannot be introduced in all locations across Estonia immediately, but will be implemented in stages.

"We started with Tartu and Tartu County, where screening will continue this year. Viljandi County will then be added, and the plan is to move on to Ida-Viru and Saare counties, depending on the capacity of doctors, hospitals and other specialists," Suurna said.

According to Suurna, the research completed over the first two to three years has shown quite clearly that screening can help detect lung cancer in patients much earlier.

"This is one of the main aims of lung cancer screening – to detect lung cancer as early as possible, because it is known to be a disease that is often diagnosed too late, in a situation where the prognosis for treatment is very poor and people do not live very long. Screening is the only way to detect lung cancer early enough for it to be treated and therefore enable people to live longer," said Suurna.

"Screening for lung cancer would have huge benefits in terms of prolonging people's lives, as well as in financial terms – the earlier it is detected, the easier and quicker it is to treat," said Suurna.

On Thursday, according to news from University of Tartu Hospital, this year, for the first time in Estonia, a study on a cardiovascular disease – abdominal aortic aneurysm – is set to be launched in order to help diagnose it at an earlier stage. The pilot project, funded by the Health Insurance Fund and the University of Tartu Hospital, is open to men aged 65 from Tartu and Tartu County as well as Tallinn and Harju County.

"This is [Estonia's] first major national non-cancer screening program," said Suurna.

A pilot prostate cancer screening program is also currently underway in Estonia under the auspices of the Estonian National Institute for Health Development (TAI). "In the case of both prostate cancer and aortic aneurysm, we are still talking about a pilot study. In other words, research to find out whether it makes sense to do this kind of screening in Estonia," Suurna said.

The potential harm caused by cancer screening is generally low, though some do occur.

"For example, there can be psychological harm caused when a person is waiting for the results of a primary examination and they do not know whether everything is fine or if there will suddenly be some terrible news. Although very few people who undergo an initial examination are ever told that they need any further tests, it can also be psychologically difficult if a person finds out that something is not quite right and does need additional tests," Suurna explained.

Lung cancer and breast cancer screening also involve the use of medical radiation. In that case too, the process is closely monitored and checked to ensure everything remains in balance.

There are currently three national cancer screening programs in Estonia –  for cervical, breast and colorecta cancers, which have been operating for 10-20 years.

As both international and Estonian experience shows incidences of colorectal cancer are increasing among younger people, Estonia has begun to reduce the age of its target group for colorectal cancer screening this year.

"Last year, the youngest men and women to receive invitations for screening were aged 60, while in 2025 the youngest will be 58. The European recommendation is to start inviting people from the age of 50, and we are moving in that direction so that younger people – aged 50 plus – can also be invited for colorectal cancer screening," said Suurna.

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