Background: Lung cancer is the leading cause of cancer death and the fourth most common cancer in Australia, with a disproportionate burden on Aboriginal and Torres Strait Islander peoples (1). International evidence shows that low-dose computed tomography (LDCT) screening can significantly improve earlier detection and reduce lung cancer mortality (2), but few countries have an organised national screening program. Challenges around implementing lung cancer screening programs include workforce and infrastructure capacity and access constraints, concerns about false-positives and overdiagnosis, and patient-level barriers such as fear and stigma.

Objectives:  Cancer Australia undertook a multi-phased project to understand the benefits, harms, cost-effectiveness and feasibility of targeted lung cancer screening, and to design a targeted lung cancer screening program for Australia, to inform a Government decision on implementation.

Methods:  In 2019, Cancer Australia commenced a lung cancer screening enquiry to assess the prospects, process and delivery of a potential lung cancer screening program. This work was informed by international evidence of effectiveness and safety, cost-effectiveness, and feasibility modelling, incorporating integration into existing health infrastructure. Following completion of this work, Australia’s Medical Services Advisory Committee (MSAC) recommended introducing a National Lung Cancer Screening Program (NLCSP). The Australian Government announced the NLSCP in 2023.
Implementation of the NLCSP was led by the Department of Health, Disability and Ageing in collaboration with Cancer Australia and the National Aboriginal Community Controlled Health Organisation (NACCHO), guided by the four priority reforms of the National Agreement on Closing the Gap and principles of equity and co-design to ensure cultural safety and accessibility. Implementation activities were overseen by three key advisory groups (Cancer and Population Screening Committee, an Expert Advisory Committee and a Program Advisory Group) and informed by a multi-faceted stakeholder consultation and engagement strategy.

Results: The NLCSP launched on 1 July 2025 as Australia’s first new national cancer screening program in nearly two decades. People eligible to participate are those who are asymptomatic, aged 50 to 70 years, current or former smokers and have a ≥30 pack-year cigarette smoking history. The NLCSP offers LDCT scans to eligible participants every two years, with a bespoke Nodule Management Protocol for following up screen-detected abnormalities.
In the six months since launch, the NLCSP has seen over 50,000 LDCT scans completed, with an average of 282 participants enrolled per day and a 55%/45% skew towards males over females. 619 of the scans undertaken to date have been categorised as ‘high’ or ‘very high’ risk according to the NLCSP’s Nodule Management Protocol, triggering
?immediate referral to a respiratory physician linked to a multidisciplinary team for further investigation.
 
Conclusion/Implications: Australia’s NLCSP represents a major advancement in cancer control. A research component has been built into the Program to support its optimisation over time and ensure it remains agile, equitable, culturally safe and accessible, and responsive to emerging evidence. The NLCSP is positioned to shift the national trajectory of lung cancer diagnosis, improve survival outcomes and reduce the burden of lung cancer across Australia.

References: 1.AIHW 2025CancerData 2. De?Koning et?al.?2020 NEJM 382:503?513.