New screening program offers hope for those most at risk of lung cancer

SBS Australia

a day ago

"We used to see a large number of people in their middle age to late middle age coming in with problems breathing or coughing up blood or losing weight, and they would have a diagnosis of lung cancer. And I remember my first consultant, Dr Ian Coutts, was a very, very gentle man and he would sit on their beds and he would hold their hands and he would tell them that he was very sorry but there was nothing that could be done." That's Dorothy Keefe speaking about her experiences of caring for patients with terminal lung cancer as a junior doctor in the UK. Now the CEO of Cancer Australia, she wants medical professionals to avoid as many of those conversations here as possible, with lung cancer the fifth most diagnosed form of the disease in Australia - but also the deadliest. Health Minister Mark Butler says it's because the condition is often picked up when it's already advanced. "It kills about 9,000 Australians every single year, or around one Australian every single hour of every single day. One of the reasons - one of the key reasons - for that stubbornly high mortality rate is the late detection of lung cancers. Usually, they're only picked up at quite a late stage in the cancer, making them very, very hard to treat - and making survivability much lower than some of the other cancers where we're seeing survivability increase quite dramatically." Anita Dessaix from the Cancer Council says lung cancer mortality is especially a problem in some migrant communities - and definitely so for Indigenous Australians, whose rates of diagnosis have been rising. "There are particular parts of the population that experience currently worser outcomes - and that does include people who are living in rural and remote areas in Australia, those who potentially don't have English as their first language - so culturally and linguistically diverse communities - and also those who are Aboriginal and Torres Strait Islander people." Now, the Australian government has funded a national early screening program it hopes will bring down those numbers. Scans to detect lung issues normally cost hundreds of dollars - but the Health Minister says that from July 1, they will cost nothing for patients deemed to be at high risk of lung cancer. Eligibility will be determined by age - those between 50 and 70 - and smoking history [[of what's calculated as at least 30 pack years*]]. "This lung cancer screening program will be targeted at Australians aged between 50 and 70 with a significant smoking history. It will entitle them to a CT scan every two years, designed to pick up any early evidence of lung cancer and allow them then to be treated hopefully very, very successfully." The Minister says rural and remote communities won't miss out. "In addition to rolling this program out nationally in the usual way - allowing people to go to their doctor and get referred for a CT scan at a place like Benson here - we'll also from later this year be rolling out trucks into regional communities with cutting-edge mobile CT technology to ensure that every single Australian, no matter where they live in the country, has access to this world-leading program." The international evidence for these types of screening programs is promising. Mark Butler says it suggests up to 70 percent of lung cancers are detected at early stages by low-dose CT scans, and deaths are subsequently reduced by 20 percent. Accordingly the CEO of the Lung Foundation Australia, Mark Brooke, hopes this program - the first new national cancer screening program in 20 years - will be a game changer. "Australia stands as leaders globally. We will be one of the first countries in the world to have a National Lung Cancer Screening Program that will look across Australia, and particularly because it's been co-designed with Aboriginal and Torres Strait Islander people, will support those people who have often been forgotten." Naomi Fitzakerley is a consumer representative for the Lung Foundation. She's concerned that those eligible will be reluctant to come forward because of the shame attached to smoking. "There is such a stigma around smoking, and one of the things that you get told is that you've caused it. If you say I have bowel cancer, they'll say, 'oh, okay, are you okay?' But if you say you have lung cancer or you have COPD or you have any sort of smoking related illness, people will all of a sudden switch off and say, 'okay, yeah, so you did that, right.' Anita Dessaix says another concern is a lack of trust in the health system that Indigenous Australians and those in migrant communities might hold. But she says the screening program has been designed with those fears in mind. "So all of those lessons learned have been built into the design and the rollout of the national lung cancer screening program. The program is designed to be equity focussed and culturally safe and person-centred. So we know that we want to ensure that the people participating in the program are having the best experience possible." Mark Brooke says that stigma - and crisis of confidence - should not stop those eligible for the screening from taking advantage of it. "Our message at the Lung Foundation is a really simple one. This is a safe procedure and we encourage everyone who meets the eligibility criteria... Do not be put off by getting this screen. It will save your life."