In her 2026 State of the Union address to the European Parliament on 16 September, European Commission President Ursula von der Leyen chose breast cancer screening as a leading example of how artificial intelligence can transform healthcare in Europe. She noted that breast cancer screening already reduces mortality by around 30-40% among women who participate and argued that AI can further improve outcomes by helping detect cancers earlier and more accurately, enabling more women to survive the disease.
At the same time, she stressed that Europe must pursue this transformation “in a European way”, with AI supporting clinicians rather than replacing them. As she put it: “AI needs to empower our doctors. Not to replace them.”
Von der Leyen identified healthcare as one of the highest-value sectors for AI deployment, highlighting both its transformative potential and Europe’s wealth of high-quality health data.
Radiology at the forefront of AI in healthcare
The President’s remarks point to radiology’s leading role in AI development and deployment in healthcare. Through policy engagement, education, research and clinical evaluation, the European Society of Radiology (ESR) actively supports the safe, ethical and effective integration of AI into medical imaging.
ESR experts have developed detailed recommendations for policymakers and the professional community on the implementation of the AI Act, addressing key areas including AI literacy, classification of high-risk AI systems, data governance, transparency, human oversight, quality management, deployer obligations, regulatory sandboxes, post-market monitoring, information sharing and market surveillance.
The ESR continues to support radiologists and healthcare providers across Europe in preparing for implementation of the AI Act, promoting regulatory clarity and facilitating the safe and effective use of AI technologies for the benefit of patients as well as expanding its educational offering to support AI literacy of the radiology workforce.
Supporting Europe’s flagship AI and cancer initiatives
With ESR’s support, radiology is playing a leading role in the implementation of flagship initiatives under Europe’s Beating Cancer Plan and the EU Apply AI Strategy. These initiatives seek to develop the infrastructure, connect high-quality datasets and establish guidance for the safe clinical deployment of AI, reflecting the “European way” of using health data responsibly while fostering innovation.
The European Institute for Biomedical Imaging Research (EIBIR), established by the ESR, coordinates Cancer Image Europe (EUCAIM), the federated European infrastructure for cancer imaging data developed under the European Cancer Imaging Initiative and the Digital Europe Programme.
Under the scientific leadership of Prof. Luis Martí-Bonmatí, Director of the Medical Imaging Department at La Fe University and Polytechnic Hospital Valencia, EUCAIM provides a secure, GDPR- and EHDS-compliant cross-border architecture enabling datasets to be discovered, accessed and used for AI training and validation without centralising patient-identifiable data. This exemplifies the “European way” of using health data responsibly while fostering innovation.
The BreastSCan project, also coordinated by EIBIR and co-funded under the EU4Health Programme, builds on EUCAIM to train and validate AI tools for image quality assessment, risk stratification, lesion detection and breast density classification. The project also promotes the AI literacy needed for clinicians to use these technologies safely and effectively. BreastSCan is assembling one of the world’s largest and most diverse breast imaging datasets, comprising more than one million mammography, ultrasound and MRI images from over 7,500 confirmed breast cancer cases.
Another flagship initiative driven by the radiology community is COMPASS AI, which aims to promote the responsible and effective integration of AI into clinical practice. The project focuses on two priority areas: cancer care and healthcare delivery in remote and underserved regions. Bringing together hospitals, professional societies and major European AI-health initiatives, COMPASS AI will establish an interactive platform to share best practices, support knowledge exchange and develop guidance on AI deployment. The project will also contribute to strengthening AI literacy among healthcare professionals, hospital managers and patients.
The need for a risk-based approach to breast cancer screening
While welcoming the recognition given to breast cancer screening in the State of the Union address, the ESR takes this opportunity to reiterate its call for a more personalised, risk-based approach to screening. Such an approach can help address recognised limitations of existing screening programmes, including underdiagnosis, false-positive findings and overdiagnosis. Evidence increasingly supports the use of supplemental imaging modalities, including MRI for women at high risk of breast cancer and women with extremely dense breasts, where they can further improve diagnostic performance.
Together with its subspecialty society, the European Society of Breast Imaging (EUSOBI), the ESR will continue advocating for evidence-based, risk-adapted screening strategies across Europe.
The role of radiology in screening and early detection
During the forthcoming EU Screening Week, ESR leadership and the ESR Patient Advisory Group will highlight, through a public-facing campaign, the critical role of imaging and radiologists in enabling earlier detection and better-informed care.
The campaign will focus on cardiovascular disease as well as breast, lung and prostate cancer, and will illustrate how AI can support radiologists in delivering high-quality patient care. Campaign information and materials as well as templates for adaptation to local languages and national contexts is available via the ESR website.
ESR in support of Europe’s AI strategy
The ESR remains in regular dialogue with EU institutions and healthcare stakeholders, providing expert input on both regulatory developments, practical deployment of AI technologies in healthcare as well as research needs.
The ESR stands ready to continue supporting the European approach to AI: one that is safe, trustworthy, responsible, accessible and resource-conscious, while delivering tangible benefits for patients and healthcare systems.
As highlighted in the State of the Union address, the European Commission is expected to unveil a series of major AI initiatives in November. The ESR is pleased that leading radiologists will contribute to these discussions, including participation in the EU Apply AI Summit on 17 November.