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Medscape
7 days ago
- Health
- Medscape
Australia Launches Lung Cancer Screening Program for Smokers
Australia has launched a government-funded lung cancer screening program that provides biennial low-dose CT scans to patients who are either current heavy smokers or who have quit in the past decade. The screening program is a 'game-changer' for Australia, Lucy Morgan, MD, PhD, respiratory physician at Concord and Nepean Hospitals in Sydney, told Medscape Medical News. 'This [program] gives us the opportunity to offer cure to people who would otherwise develop Australia's most deadly cancer.' Morgan is also chair of the Lung Foundation Australia and a member of the screening program's expert advisory committee. Early Diagnosis Crucial Shalini Vinod, MD Lung cancer is the fifth most diagnosed cancer in Australia and the most common cause of cancer death, claiming around 9000 lives per year. Survival rates for lung cancer (around one quarter of those diagnosed survive for 5 years) are far below those of more common cancers, including breast cancer, which has a 5-year survival rate of above 90%, and colorectal cancer, which has a 5-year survival rate of above 70%. The reason for the low survival rate of lung cancer is that by the time it is symptomatic, it's often advanced, said Shalini Vinod, MD, radiation oncologist at the University of New South Wales Sydney. 'Approximately in half the cases that I pick up, the cancer has spread beyond the lungs and so is incurable,' said Vinod, who is on the expert advisory committee for the program. Lung cancers that are detected early, before they have spread, have a much better prognosis and better treatment options, Vinod said. The most common approach for early lung cancer is surgery to remove the tumour or radiotherapy. 'If they're 2 centimetres or less, they're eligible for minimally invasive surgery…where rather than taking a whole lobe of the lung out, you can just take a part of the lobe with equivalent outcomes,' she told Medscape Medical News . The program, which was launched on July 1, is recruiting smokers aged 50-70 years who currently smoke or have quit in the past 10 years and have a smoking history of at least 30 pack-years. Henry Marshall, MD, PhD Only a handful of countries worldwide, including the United States, the United Kingdom, South Korea, Taiwan, and Canada, have national or regional lung cancer screening programs, which all vary slightly in the choice of screening interval, age range, and smoking history. For example, the US Preventive Services Task Force recommends yearly screening. The choice of 2-yearly screening was an effort to balance cost and benefit, said Henry Marshall, MD, PhD, a thoracic physician at the Prince Charles Hospital and University of Queensland Thoracic Research Centre in Brisbane. 'It's as effective in terms of its health benefit, but of course a lot cheaper because you're immediately halving the number of scans that you need to do,' said Marshall, who is also a member of the screening program expert advisory committee. Australia's Unique Challenges Australia faces unique challenges in implementing a national screening program like this one. The first is that lung cancer is the most diagnosed cancer and the most common cause of cancer death among Aboriginal and Torres Strait Islander people, with incidence and mortality rates around twice those of non-Aboriginal Australians. 'Some of it is about living in rural and remote Australia, some of it is about smoking rates, some of it is probably about genetic predisposition; we don't understand that completely,' said Morgan. 'And much of it is about access to health care.' To address this disparity, the program was developed in partnership with the Aboriginal Community Controlled Health Organisation sector and First Nations people to ensure that the design and implementation was community-led and culturally appropriate and that the information and education materials were tailored to the community. The program includes a mobile CT screening service to reach Australians in rural and remote areas because 'there are millions of Australians living more than four hours away from a CT scanner,' said Morgan. Five mobile screening trucks will be deployed around the country beginning in November this year. Participants must be initially referred for screening by their general practitioner (GP). If anything is detected on CT, they are then referred to another clinician according to a nodule management protocol that was developed specifically for the program. The Royal Australian College of General Practitioners has expressed concern about the potential increased workload for GPs, particularly those in areas of socioeconomic disadvantage, where greater numbers of patients are likely to have histories of heavy smoking and therefore be eligible for screening. The program will also lead to increased pressure on radiology and cardiothoracic surgery services in Australia, Vinod said, but another concern is whether smokers will actually sign up for the program. Uptake for breast cancer screening in Australia is around 50%, and uptake for bowel cancer screening is around 40%. 'If you just benchmark it against those, this is going to be tough because this is a cancer where there is a lot of stigma,' Vinod said.
ABC News
03-06-2025
- Health
- ABC News
New lung cancer screening program aims to save 12,000 lives over next decade
If Australia's new lung cancer screening program had been around earlier, Anne Fidler thinks she might have had a lot longer to live. "They probably would have caught it at stage 1 and not now at stage 4," the 62-year-old said. The Brisbane-based real estate agent, who used to smoke, went for an unrelated scan. That was when her lung cancer was picked up. "It was quite bizarre, really, because I had gone to the doctor for a gynaecological reason," she said. "I was super fit, I was going to the gym … I had no evidence, no cough, nothing." The new national screening program starts next month and is open to people with a significant history of smoking. Ms Fidler said she hoped others would not miss out on early detection. "I'm very passionate that nobody moving forward has to go through what I've gone through," she said. "Nobody deserves to have lung cancer. Whether you're a smoker or a past smoker or a non-smoker, nobody deserves it." Radiation oncologist Shalini Vinod said more women died of lung cancer than breast cancer and more men died of lung cancer than prostate cancer. She said not only was lung cancer Australia's deadliest cancer, killing almost 9,000 people a year, the five-year survival rate for lung cancer was just 26 per cent, compared to breast cancer, which was 92 per cent. "When patients are diagnosed, about half of them will present with advanced disease … and that means the lung cancer is incurable and survival is poor," Professor Vinod said. "The idea of lung cancer screening is to try and detect these cancers at a much earlier stage where they can have curative treatment. Chief executive officer of the Lung Foundation Australia, Mark Brooke, said he was optimistic the program would bring hope for lung cancer patients by achieving similar results to the screening programs already in place for colorectal, cervical, and breast cancers. On top of the 15,000 cases of lung cancer already detected each year, respiratory specialists expect an extra 1,500 cases will be picked up in Australia annually through the screening program. It is hoped it will save 12,000 lives in its first 10 years. "We have a whole range of treatments that can absolutely turn around and improve your chances," Mr Brooke said. He said while the increase in diagnoses of early-stage lung cancer would increase pressure on the health system to treat more patients, it would ultimately cut costs. "It costs nearly $60,000 per patient to diagnose them at stage 4 and up to $17,000 depending upon the treatment for patients being diagnosed at stage 1." The screening program will offer a bulk-billed low-dose CT scan for the 930,000 people estimated to be eligible for the program in the first year. Mr Brooke said the eligibility criteria targeted a demographic of people who grew up at a time when smoking was much more common than it is today. "Growing up in the 70s and 80s, when smoking rates in Australia were up around 60 per cent… [these people will] be in their 50s and 70s as this program is introduced," he said. "It was less than 30 years ago that we were allowed to smoke in our workplaces, in our motor vehicles, in our own homes, indoors in pubs and nightclubs." The program will focus on First Nations communities — which have a higher incidence rate of lung cancer — as well as people from culturally and linguistically diverse backgrounds and rural and remote areas. Vans fitted with screening technology will travel to remote areas to ensure people have convenient access to the service. "This is the first-ever screening program that has been co-designed with Aboriginal and Torres Strait Islander communities," Mr Brooke said. A third of lung cancer cases are not linked to smoking. Professor Vinod said for now the screening would only be open to people who have smoked, but hoped eligibility might widen at a later date. "It doesn't mean we don't care about those who don't smoke, but I think we have to get started somewhere," she said. Do you have a story to share? Email While Anne Fidler's cancer is incurable, for now, she is in a good place, enjoying time with her adult children, her grandchild and ticking things off her bucket list, such as overseas travel. "I'm extremely grateful that I am very well and my cancer is very stable at the moment," she said. Anne said she wanted those eligible to take advantage of the new program and for it to break down some of the shame and stigma around lung cancer. "I think the problem with lung cancer is that everyone goes 'oh well, you're a smoker, right?' Like it's your own fault, [like] you deserve it. People who have lung cancer with no history of smoking also experience the shame associated with the illness. Mr Brooke said Lung Foundation surveys showed one in three respondents believed if someone was diagnosed with lung cancer it was their own fault. "That stigma of lung cancer has held back community empathy, fundraising, research, investment and, in some cases, the quality of care that patients receive." And for some, it is potentially deadly. "We know from talking to patients that they have withdrawn from care or not sought care because they feel guilty about being a person who currently smokes or who has previously smoked," Mr Brooke said. For people who already have potential symptoms of lung cancer, and therefore ineligible for the screening program, the Health Department recommends consulting with your GP about more in-depth lung testing. Symptoms of lung cancer include changes in coughing, coughing up blood, shortness of breath, fatigue, weight loss, or persistent chest or shoulder pain.
