To view the full text, please login as a subscribed user or purchase a subscription. Click here to view the full text on ScienceDirect. Fig. 1 Graphical description of different screening models and the key components involved. Highlights •Lung cancer screening with LDCT has the potential to reduce lung cancer mortality. •Widescale implementation, if to be considered, must overcome numerous challenges. •This review considers the evidence and asks: are we ready to implement in Europe?.