Background: The 2022 European Union (EU) cancer screening recommendations advised Member States to: (1) improve screening programmes for breast, cervical, and colorectal cancers, and (2) assess the feasibility and relevance of implementing lung, prostate, and gastric cancer screening programmes (with Helicobacter pylori screen-and-treat strategies for the latter). The EU recommendations included the following innovations: (1) optimizing screening access through self-administered cancer screening tests; and (2) optimizing screening quality by tailoring cancer screening regimens according to individual risk. Additionally, although the evidence base supporting artificial intelligence (AI)-aided cancer detection was deemed immature, some healthcare settings are integrating AI into their clinical workflows to improve diagnostic efficiency.
 
Objectives: We conducted a rapid review and country case studies to identify promising approaches for facilitating real-world implementation of the identified cancer screening and early detection innovations, namely: (1) self-sampling, (2) risk-stratified screening, and (3) AI-aided early detection and diagnosis.
 
Methods: We searched MEDLINE, the Cochrane Library, and Google Scholar for systematic reviews published between 2020 and 2025 and included studies that discussed implementation of self-administered testing, risk-stratified screening, and AI-aided cancer detection for any of the six cancers of interest in high-income countries. Additional references were retrieved through supplementary free-searching, snowballing, and expert consultation. We also conducted country case studies of successful implementation (England, Ireland, the Netherlands, Portugal, and Sweden) by engaging experts working in national cancer screening programmes. We described both innovation- and cancer-specific approaches that may enable implementation and identified cross-cutting considerations.
 
Results: The electronic database search identified 2,333 records. Following the systematic screening and selection processes, as well as supplementary searching and expert consultations, 150 references were included. Direct mailing of self-administered test kits and provision of patient navigation and public health education have been associated with greater and more equitable cancer screening uptake. Risk-stratified screening involves significant alterations to the screening pathway due to the introduction of a risk assessment process. The setting, timing, and delivery of risk assessment are highly context-specific and require local adaptation and evaluation. Primary care providers and electronic health records may be best suited for administering risk assessment, populating risk models, and managing the follow-up according to the identified risk profiles. Developing explainable AI models, providing health professional training, and creating patient communication tools to support shared decision-making may enable greater adoption of AI-aided cancer detection in clinical practice. Overall, ensuring health professional, patient, and public acceptability of cancer screening innovations and resourcing rigorous testing and validation of new technologies using robust and representative population health datasets are important for effective implementation.
 
Conclusions/Implications: Although there is limited evidence regarding how best to implement cancer screening innovations in the real world, this review identified emerging approaches that may aid the EU Member States in acting upon the recent EU cancer screening recommendations.