Lung cancer program delivers early results but exposes system pressures

Almost 100,000 Australians at high risk of lung cancer have been screened in the first year of the National Lung Cancer Screening Program, with more than 230 primary lung cancers detected. However, while early results point to important benefits, experts warn the program’s full potential could be limited by persistent gaps across the health system.

Lung cancer remains Australia’s leading cause of cancer death, claiming an estimated 9,000 lives each year, approximately one person every hour. Yet early detection has the potential to transform outcomes by lifting the five-year survival to almost 70% compared with less than 5% for advanced disease.

Mark Brooke, CEO Lung Foundation Australia, said “We are already seeing the impact of detecting lung cancer earlier, when treatment can be more effective and outcomes significantly improved.”

As the first major national cancer screening initiative introduced in two decades, the program is now enrolling more than 285 Australians each day. It employs low-dose CT imaging to screen individuals at elevated risk, including those aged 50 to 70 with a history of smoking.

The program is also expanding access through mobile screening services, which have commenced in northern Western Australia and the Northern Territory to bring screening closer to rural and remote communities where fixed services remain limited. Through a partnership with Heart of Australia, 519 mobile scans have already been completed, with additional mobile services expected to be introduced across the remaining states over the next 10 months.

Dr Dawn Casey PSM, CEO National Aboriginal Community Controlled Health Organisation (NACCHO), said “Strong uptake of lung cancer screening by Aboriginal and Torres Strait Islander people in the program’s first year is not a happy accident; it is what happens when screening is built to be culturally safe, delivered through Aboriginal Community Controlled Health Organisations, and backed by a growing Aboriginal and Torres Strait Islander cancer workforce.”

Despite the early indicators of success, a national survey conducted by Thoracic Society of Australia and New Zealand (TSANZ) and Lung Foundation Australia has highlighted significant structural challenges affecting lung cancer care. Fewer than 50% of multidisciplinary teams (MDTs) have a dedicated Specialist Lung Cancer Nurse (SLCN) on-site, while only 36% of institutions routinely review all newly diagnosed patients through an MDT process. Many services, particularly outside major metropolitan areas, also continue to experience limited access to specialist surgeons, advanced diagnostic testing and personalised treatments such as next-generation sequencing.

“We cannot allow postcode to determine outcome,” said lead author of a recently published research, Professor Fraser Brims from the Institute for Respiratory Health. “The culture needs to change. We must set the standard of care based on what patients need rather than what existing infrastructure allows. We need innovation, not compromise.”

The development of a national lung cancer screening program commenced in 2019, when Cancer Australia was commissioned by the federal government to evaluate feasibility, delivery frameworks, and implementation pathways. This process culminated in the program’s formal launch in July 2025.

A formal review of the program is scheduled within the first two years of implementation. Oversight of monitoring and reporting will be undertaken by the Australian Institute of Health and Welfare, with annual reporting obligations in place and the first report expected in June 2027.

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