The National Lung Cancer Screening Program has been operational for a year, with approximately 100,000 Australians screened since July 2025. However, the focus has shifted from the merits of screening to the health system's capacity to deliver timely follow-up and treatment.
Screening Program Overview
The program uses low-dose CT scans for high-risk individuals aged 50–70 who currently smoke or have quit within the past ten years, with a smoking history of at least 30 pack-years. The goal is early detection, as lung cancer remains Australia's leading cause of cancer deaths, claiming more lives than breast and bowel cancer combined. In 2025, over 15,000 Australians were diagnosed with lung cancer.
Workforce and Service Gaps
Despite the program's launch, significant gaps in lung cancer services persist. A recent survey revealed that only four in ten institutions have the recommended core workforce for multidisciplinary lung cancer team meetings. Around one in four institutions lack specialist lung cancer nurses, who are crucial for coordinating care and guiding patients through the treatment pathway.
Shortages are most acute outside major cities, with gaps in thoracic surgeons, nuclear medicine specialists, and access to personalised molecular testing. This geographic disparity means that for regional and remote patients, screening may be accessible, but timely treatment remains dependent on postcode.
Equity Concerns
Aboriginal and Torres Strait Islander peoples face a disproportionate burden of lung cancer, with higher diagnosis and mortality rates. The screening program was co-designed with Cancer Australia and the National Aboriginal Community Controlled Health Organisation, but equity hinges on culturally safe access, timely follow-up, and proper support for Aboriginal community-controlled services.
Missed Opportunity for Smoking Cessation
The screening program encourages clinicians to support smoking cessation, but there is no Medicare Benefits Schedule item number to fund this support. This represents a missed opportunity, as screening is a time when many are motivated to quit.
Data and Monitoring
Australia lacks nationally consistent data to assess where services are working well. Different hospitals use varying quality indicators, preventing comparison and near-real-time feedback. Without this data, it is unclear whether the program is narrowing health equity gaps or merely revealing them earlier.
According to experts, if these issues are not addressed, the program will detect more early-stage lung cancers but fail to deliver timely treatment, leading to fragmented care and avoidable disparities in outcomes and survival.
