A/Prof Nicole Rankin and Ms Rebecca Zosel – Evaluation and Implementation Science Unit, Melbourne School of Population and Global Health, University of Melbourne
On 1 July 2025, Australia launched its first targeted cancer screening program: the National Lung Cancer Screening Program. This landmark public health initiative is set to transform how we address Australia’s number one cause of cancer death – lung cancer. Led by the Department of Health, Disability and Ageing, in partnership with Cancer Australia and the National Aboriginal Community Controlled Health Organisation (NACCHO), the program represents the culmination of more than 40 years of global research into early detection and screening efficacy. Its implementation is a defining moment for cancer control in Australia.
The case for screening
The evidence is compelling. Two major randomised controlled trials – the NLST (US) and NELSON (Europe) found that low-dose computed tomography (CT) scans reduce lung cancer mortality by 20-24% compared to chest x-rays or usual care. Importantly, low-dose CT can detect lung cancer at an early, more treatable stage – before symptoms emerge. While potential harms such as overdiagnosis and unnecessary surgical biopsies exist, these risks are minimised through robust program design, quality assurance, and program evaluation – all embedded in Australia’s approach.
Who is eligible? The program targets people aged 50-70 years who:
- Have no signs or symptoms suggestive of lung cancer
- Currently smoke or quit within the last 10 years
- Have a history of cigarette tobacco smoking of at least 30 pack-years.
What does the Program involve? Eligible individuals require a referral from a GP, specialist or nurse practitioner for a low-dose CT scan, which is available at many private and public radiology services across Australia. Enrolment through the National Cancer Screening Register – now expanded to include lung cancer – is also an important step.
Why now? Australia joins just 13 countries worldwide with a targeted national lung cancer screening program. Many other countries are preparing for implementation and considering policy change. Now is the time for major change in the poor five-year survival rates of just 26% for lung cancer.
What are the likely outcomes? The program is expected to save more than 500 Australian lives in its early years. To achieve this impact, healthcare providers play a vital role – by encouraging people with a history of smoking to check their eligibility and supporting them through shared decision-making. This ensures people can make informed choices about whether screening is right for them.
Why is the Program significant for Australian research? For Australia’s small but committed community of lung cancer screening researchers, the program represents a rare and powerful opportunity for research translation. While the evidence base on screening efficacy is well established, global experts stress the need to shift focus toward implementation research – addressing the well-known ‘know-do-gap’ of up to 17 years between research discovery and real-world practice.
Call to action
Implementation research must now be a national priority. To realise the full potential of this groundbreaking program, we need investment in research that supports optimal rollout, equitable access, and continuous improvement. Healthcare providers and eligible participants also have a role to play, by engaging in screening conversations and contributing to the program’s success. The Evaluation and Implementation Science Unit in University of Melbourne’s School of Population and Global Health play a leading role, having been commissioned to write the Program Guidelines and funded by MRFF to conduct the first Australian implementation trial testing strategies to optimise participation.
For more information, visit our website: https://mspgh.unimelb.edu.au/centres-institutes/centre-for-health-policy/evaluation-implementation-science
