A Comprehensive National Strategic Framework for Lung Cancer Prevention and Control in Libya a Multi-Sectoral Four-AxisIntervention Model for High-Risk Populations

Abstract

Background
Libya is currently facing a significant and preventable cancer crisis, with lung cancer emerging as the leading cause of cancer-related mortality. Tobacco smoking accounts for approximately 81% of lung cancer cases; however, the country lacks a unified national prevention plan. Despite the availability of effective global primary and secondary prevention strategies—including tobacco taxation, smoke-free legislation, smoking cessation programs, and Low- Dose Computed Tomography (LDCT) screening—Libya has not implemented these evidence-based interventions. This deficiency has resulted in increasing incidence rates, alarmingly high mortality, and considerable health inequalities across the nation.

Objective
To develop and present a contextually appropriate, evidence-driven National Strategic Framework for the prevention and control of lung cancer in Libya, structured around four interconnected and mutually supportive intervention pillars.

Methods
This conceptual framework was developed using a multi-stage, multi-method approach including epidemiological assessment, policy and regulatory review, best practice synthesis, contextual adaptation, and stakeholder consultation. The framework was organized based on the “Continuum of Care” model, divided into four intervention axes.

Results
The comprehensive four-axis framework includes: Tobacco Control—requiring legislative reform including tax increases to at least 75% (currently 32%), repeal of the ban on Nicotine Replacement Therapy (NRT), and enforcement of smoke-free laws; Early Detection through LDCT—a phased national screening program for high-risk individuals (aged 55–77 years with ≥30 pack-year history), projected to detect early-stage cancer in 70% of cases and reduce mortality by up to 25%; Infrastructure Development—establishment of a comprehensive National Lung Cancer Registry, local molecular pathology capacity, and sustainable pharmaceutical supply chains; and Community Engagement and Patient Support—multi-platform awareness campaigns, psychosocial support
services, and financial protection mechanisms through a National Cancer Care Fund. Implementation of this approach is expected to reduce lung cancer mortality by 20–30% over the next decade [1-4].

Discussion
Key implementation challenges include institutional coordination deficits, resource constraints, the influence of the tobacco industry, and historical disruptions to healthcare systems. Legislative strengthening, multi-sectoral collaboration, and technical support from the World Health Organization are identified as essential success factors. The tobacco industry regulations require coordinated enforcement and adherence to international standards.

Conclusion
The proposed four-axis model provides a pragmatic pathway to address the escalating lung cancer burden in Libya. Success hinges upon decisive government leadership, sustained international collaboration, robust civil society mobilization, and strengthened institutional capacity across all Libyan cities and municipalities.