RANZCR: Cancer Australia Advises the Formation of a National Lung Cancer Screening Program

In August 2019, the Australian Minister for Health, The Hon. Greg Hunt MP, requested that Cancer Australia conduct an enquiry into the prospects, process and delivery of a national lung cancer screening program in Australia. Following from this work, Cancer Australia is formally advising the Australian Federal Government to create a national lung cancer screening program, saying it would save 12,000 lives over the next decade.

In its Report on the Lung Cancer Screening Enquiry, Cancer Australia said based on the national and international evidence, a screening program using biennial low dose computed tomography (LDCT) in asymptomatic high-risk Australians could detect cancers in their early stages when treatment is most likely to be successful. Such a screening program would save lives, reduce lung cancer mortality in Australia by 20 per cent in the screened population, and improve the survival and quality of life of Australians affected by lung cancer* .

The College is in the final stages of developing a position statement to assist with advocacy to governments to address key issues that may affect the successful design and implementation of a lung cancer screening program. The College is recommending governments in Australia and New Zealand:

1. Develop a national strategy for lung cancer screening to prioritise low-dose computed tomographic (LDCT) screening for specific at-risk populations. The College was pleased to see LDCT detailed as the recommended screening tool in Cancer Australia’s report.

2. Use a targeted risk screening approach by containing the patient population eligible for the screening program to individuals at high risk.

3. Establish a national funding model to ensure equitable access to the lung cancer screening program.

4. Focus on national campaigns to prevent young people smoking and broader public health campaigns around smoking cessation among dependent smokers.

5. Ensure a strong national policy commitment to address the burden of lung diseases with focus on reducing occupational risk, ensuring equitable access to treatment and services, investing in research and tackling stigma.

The College believes that the criteria underlying a national lung cancer screening program should:

1. Ensure there is evidence of improved mortality, morbidity or quality of life as a result of screening and that the benefits of screening outweigh any harm.

2. Facilitate the provision of timely, appropriate, high-quality and safe diagnostic assessment.

3. Ensure screening is targeted at individuals without overt signs and symptoms of the disease and as such can detect disease at an early stage.

4. Ensure equitable access for all in the target population in order to limit the loss of opportunity focusing on lifting barriers to vulnerable populations.

5. Encompass review as part of the Population Based Screening

Framework requirements to ensure an evidence-based approach to screening and the continued inclusion of new evidence from emerging population studies.

6. Address the risk of stigmatisation to ensure full participation so that priority cohorts can realise the benefits offered by lung cancer prevention, control, and treatment.

The College will continue to keep members updated as this important advocacy work continues. If you have any questions or comments, please direct them to professionalpractice@ranzcr.edu.au

* Report on the Lung Cancer Screening Enquiry, www.ranzcr.com/documents/5265-report-on-the-lungcancer-screening-enquiry-by-cancer-australia/file