In Australia, lung cancer is the fifth most commonly diagnosed cancer and is the leading cause of cancer death.¹  In 2024, an estimated 15,122 new cases were diagnosed.² While lung cancer age-standardised incidence rates have been stable (57 cases per 100,000 people in 2000 to an estimated 56 cases in 2024),³ incidence rates have decreased for males, while increasing for females.¹

Factors associated with a higher risk of developing lung cancer include the following:³

• Lifestyle: Tobacco smoking (current or past), particularly if started early, frequent, or long-term.
• Environmental/Occupational: Exposure to second-hand smoke, air pollution, and hazardous substances like radon, asbestos, diesel exhaust, and silica.
• Personal: Older age, family history of lung cancer, chronic lung conditions (e.g. COPD, pulmonary fibrosis), prior cancer (especially lung, head or neck), past chest radiation, HIV infection, and specific genetic mutations.

The National Lung Cancer Screening Program was launched in July 2025. This is a targeted screening program using low-dose computed tomography (low-dose CT) scans to look for lung cancer in high-risk people who do not have any signs or symptoms suggestive of lung cancer.⁴ Large international randomised trials have shown at least a 20% reduction in deaths from lung cancer when participants are screened using low-dose CT scans, and that up to 70% of lung cancers found during screening are detected at early stages.^5,6

Approximately 3% of people screened will have a high risk or very high-risk nodule found.⁷ Of these high risk or very high-risk nodules, 48% will be a lung cancer.⁷ Around 1 in 30 lung cancers found during screening are slow growing and may not cause problems for that individual patient, representing overdiagnosis.⁷ The low-dose CT scan may identify actionable additional findings (e.g. coronary artery calcification, other lung disease) which may require GP follow up.

Role of the GP in the National Lung Cancer Screening Program

GPs are responsible for identifying and assessing patients for eligibility, determining if a low-dose CT scan is appropriate, help patients make informed decisions and order the low-dose CT Scans. GPs (or their delegates) also enrol eligible patients via the National Cancer Screening Register (NCSR), offer smoking cessation support, communicate results, and make specialist referrals where needed. Additionally, they manage follow-up for incidental findings and ensure access to social, emotional, and wellbeing support.¹⁰

To support GP understanding of their role in the National Lung Cancer Screening Program, refer to the National Lung Cancer Screening Program – Requesting practitioner flow chart for eligibility and CT scan referral resource and to the National Lung Cancer Screening Program – General practitioner resource guide for more information.^a

Screening and assessment pathway

Refer to the National Lung Cancer Screening Program – Screening and assessment pathway resource and the National Lung Cancer Screening Program – Guidelines summary for information on this.

Program eligibility and shared decision making

Eligible participants are not required to quit smoking to participate in the program. Once an individual is participating in the program, their smoking history eligibility criteria does not need to be reassessed. To remain eligible, the participant must be aged between 50-70 and be asymptomatic of lung cancer. The participant can continue to screen if their quit smoking duration exceeds 10 years. The participant remains eligible to continue in the program until they age out (turn 71 years), become unable to undergo a low-dose CT scan or have findings on scans that mean they exit the program. See section on Program exit and re-entry in the National Lung Cancer Screening Program. Program Guidelines.

More information is available in the National Lung Cancer Screening Program – Shared decision-making and informed choice for lung cancer screening: a guide for healthcare providers and the National Lung Cancer Screening Program – Conversation guide: Discussing participation. A proxy approach to assessing eligibility has been developed by the Aboriginal Community Controlled Health Service sector to support practitioners in situations where determination of pack-year history is not feasible. This is available on the NACCHO website.

Once the participant in enrolled in the programme, please refer to the National Lung Cancer Screening Program – General practitioner resource guide for further information on participant management.

Low-dose CT suitability and low-dose CT requesting

A requesting practitioner should check the suitability to have a low-dose CT scan of all people eligible to participate in the program prior to issuing a low-dose CT scan request.

People may be considered unsuitable for low-dose CT if:

• Weight exceeds restrictions of scanner (>200kg depending on the scanner)
• Unable to lie flat for a minimum of 5 minutes and hold their hands above their head
• Symptomatic lung infection (e.g. COVID-19, pneumonia, bronchitis, lower respiratory tract infection with productive cough) within the previous 12 weeks. Those who are unsuitable solely due to an active infection can be re-evaluated and may become suitable 12 weeks after recovery.
• A full CT scan of the chest has been undertaken within last 12 months or is planned for clinical reasons in the next 3 months (for example, active cancer surveillance). 

A National Lung Cancer Screening Program CT request form is available online and in Clinical Information Software (Best Practice, Medical Director, Communicare and MMeX) and is integrated similarly to other diagnostic imaging forms. It is important to use the screening specific CT request form to track patient participation and results, and for the radiology report to be structured in line with clinical guidance.

^aFor information on the roles of non-GP practitioners in the National Lung Cancer Screening Program, refer to National Lung Cancer Screening Program information for healthcare providers.

Aboriginal and Torres Strait Islander peoples are a priority population in the program due to differences in smoking prevalence and inequities in access to optimal and culturally safe and appropriate healthcare, which significantly impacts lung cancer diagnosis, mortality, and survival rates. Despite a significant downward trend, approximately 29% of Aboriginal and Torres Strait Islander peoples smoke meaning they are likely to make up a disproportionately large segment of the eligible screening population. In addition, the lung cancer survival rate for Aboriginal and Torres Strait Islander peoples is 11% at five years post diagnosis compared to 16% for non-Indigenous Australians.¹¹ Such impacts and loss to communities may affect participation rates (eg. due to stigma and nihilism) and the participation experience.⁴

For recommendations specifically developed with and for Aboriginal and Torres Strait Islander people, please refer to the Lung cancer and Smoking chapters of the RACGP & NACCHO National guide to preventive healthcare for Aboriginal and Torres Strait Islander people.

Aboriginal and Torres Strait Islander Health Workers and Health Practitioners also have a key role to play across all stages of the National Lung Cancer Screening Program, including raising awareness, engaging community, delivering smoking cessation advice, enhancing efforts to identify eligible clients and supporting eligible participants through the Program.

Resources to assist with assessing smoking history eligibility, and engaging in shared decision-making with Aboriginal and Torres Strait Islander patients can be found on the NACCHO website.

The following groups have been identified as priority populations for the National Lung Cancer Screening Program due to an increased risk of lung cancer in these groups.⁴ The program and supporting guidelines are designed to help meet the needs of these priority populations to achieve equity and benefit all eligible patients.

Some people may identify with one or more of the following groups:

• Aboriginal and/or Torres Strait Islander peoples
• People living in rural and remote areas
• People from culturally and linguistically diverse (CALD) backgrounds
• People with disability
• People with mental illness
• People from Lesbian, Gay, Bisexual, Transgender, Intersex, Queer and Asexual (LGBTIQA+) communities⁵

Supporting smoking cessation: a guide for health professionals | RACGP
National guide to preventive healthcare for Aboriginal and Torres Strait Islander people | RACGP & NACCHO
National Lung Cancer Screening Program Guidelines | Australian Government
National Lung Cancer Screening Program – Resources for the health sector | Australian Government