Australia’s National Lung Cancer Screening Program at Risk Without Urgent Investments: Curtin University MJA Study

The Launch of Australia's National Lung Cancer Screening Program and Its Transformative Potential

Australia's National Lung Cancer Screening Program (NLCSP), officially launched on July 1, 2025, marks a pivotal moment in the fight against the nation's deadliest cancer. This government-funded initiative provides free low-dose computed tomography (LDCT) scans to eligible high-risk individuals aged 50 to 70 years with at least a 20 pack-year smoking history who are current smokers or have quit within the last 15 years. By detecting lung cancer at earlier, more treatable stages, the program aims to boost five-year survival rates from the current dismal 27% overall—rising to nearly 70% for early-stage diagnoses—to save hundreds of lives annually.

Early data shows promising uptake, with over 60,000 enrollments by early 2026, including around 290 daily registrations through the National Cancer Screening Register. Mobile screening units are rolling out to reach rural and remote areas, ensuring broader access. However, as Curtin University researchers caution, realizing this potential hinges on addressing deep-rooted systemic gaps in lung cancer care.

Curtin University's MJA Study Exposes Alarming Risks to NLCSP Success

In a timely Medical Journal of Australia (MJA) perspective published February 22, 2026, Professor Fraser Brims from Curtin University's Medical School warns that without urgent investments, the NLCSP risks falling short of its life-saving goals. Titled "National Screening, National Responsibility: Turning Promise Into Progress for Lung Cancer Care," the paper draws on national surveys and data to highlight how inadequate infrastructure could undermine early detections.

Brims, a respiratory medicine expert affiliated with Curtin, Sir Charles Gairdner Hospital, and the Institute for Respiratory Health, emphasizes: "Screening does not save lives on its own." His analysis reveals only 41% of lung cancer-treating institutions have core multidisciplinary teams (MDTs), with half lacking specialist lung cancer nurses—roles proven to improve survival and reduce admissions.

The Stark Burden of Lung Cancer on Australian Society

Lung cancer claims more Australian lives than breast and prostate cancers combined, with an estimated 15,108 new diagnoses and 8,994 deaths in 2025 alone—projected to rise for at least two decades. The age-standardised incidence rate stands at 55 per 100,000, with Aboriginal and Torres Strait Islander peoples facing twice the incidence and mortality rates of non-Indigenous Australians due to inequities in access and prevention. Survival lags globally at 27% five-year rate (2017-2021 data), burdened by late diagnoses in over 80% of cases.

Economically, it costs billions yearly, forecasted at $8.3 billion by 2031, yet receives disproportionately low research funding. Universities like Curtin play a vital role in bridging this through evidence-based advocacy and trials informing policy.

Critical Gaps in Multidisciplinary Lung Cancer Care

The Curtin-led MJA study spotlights profound deficiencies in MDTs, essential for optimal staging, treatment, and outcomes. A national survey found:

• Only 41% of institutions possess the recommended core MDT workforce (respiratory physician, oncologist, radiologist, pathologist, thoracic surgeon, radiation oncologist, lung cancer nurse).
• Barely one-third discuss all lung cancer cases weekly.
• Shortages in thoracic surgeons and nuclear medicine specialists, worse in non-metropolitan areas.

Patients in MDT-discussed cases receive better staging, guideline-concordant therapies, and survival. Specialist lung cancer nurses cut early death risk and boost systemic therapy uptake, yet half of sites lack them—a gap Curtin research has quantified across Australia and New Zealand.

Managing Incidental Findings: A Hidden Challenge Exposed by Curtin Research

LDCT scans reveal incidental findings in 73% of high-risk participants, with 10-17% needing follow-up—coronary calcification (69%), emphysema (54%), and others like vertebral issues. Brims co-authored a 2025 MJA study from the International Lung Screen Trial showing higher actionable rates in Australia (16.7%) vs Canada (4.5%), urging standardised reporting for the NLCSP to avoid unnecessary tests and costs.

Without protocols, these could overwhelm systems, diverting from cancer care. Curtin's work underscores universities' role in pre-empting such issues through prospective trials.

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Personalised Medicine and Access Disparities

Next-generation sequencing (NGS) for targeted therapies is uneven, with rural and public patients underserved. Public hospitals lag in guideline adherence and survival vs private. The MJA paper calls for universal NGS access to leverage biomarkers driving 21st-century care.

Smoking cessation integration is absent in most centres, despite evidence it amplifies screening benefits. Loss of Medicare item numbers exacerbates this.

The Imperative for a National Lung Cancer Clinical Quality Registry

Australia lacks a unified registry, unlike breast or bowel screening, leading to care variations. Curtin advocates a state-of-the-art platform for benchmarking, real-time audits, and research linkage—tracking MDT use, NGS, outcomes to drive equity and innovation.

Such registries, pioneered in universities, transform care as seen overseas.

Addressing Inequities for Aboriginal and Torres Strait Islander Peoples

With double the burden, targeted efforts via NACCHOs (National Aboriginal Community Controlled Health Organisations) are essential. Culturally safe screening, cessation, and MDTs are needed, informed by Curtin-like research closing gaps.

Curtin University: Pioneering Research to Shape Policy

Curtin Medical School, under leaders like Brims (3,200+ citations), drives lung cancer advances via trials like ILST and surveys exposing gaps. Their MJA contributions position universities as policy influencers. For aspiring researchers, explore research jobs at institutions like Curtin. Brims' work exemplifies higher ed's translational impact.

Global Lessons and Economic Imperative for Investment

US NLST trial cut mortality 20%; Australia must match with infrastructure. Projected $8.3b costs demand investment in MDTs, nurses, registries—yielding ROI via saved lives, productivity.Read the full MJA study.

Stakeholders urge coordinated funding; universities train the workforce needed.

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Pathways Forward: Actionable Insights and Optimism

Brims calls for cultural shift: "Innovation, not compromise." Priorities: Fund nurses, MDTs, registry; embed cessation; boost uni-led research. With action, NLCSP transforms outcomes. Interested in higher ed careers in health research? Visit higher-ed-jobs, rate-my-professor, or higher-ed-career-advice for guidance and opportunities.