The National Lung Cancer Screening Program will commence on 1 July 2025.

The establishment of a National Lung Cancer Screening Program allows Cancer Australia to partner with the National Aboriginal Community Controlled Health Organisation (NACCHO) and  to oversee priority population groups who are disproportionately impacted by lung cancer.

As an implementation partner, NACCHO lead the co-design of the program to ensure culturally safe and appropriate screening services are available for Aboriginal and Torres Strait Islander people.

Patients aged between 50-70 years will be eligible for the screening program if they had a smoking history of at least 30 pack-years, (one pack-year is defined as smoking 20 cigarettes a day for one year) and either continued to smoke or had quit smoking within the past 10 years.

From a diagnostic imaging perspective, there will be a requirement for specific acquisition and reconstruction protocols based on the following technical parameters.

They are:

• An acquisition protocol for a Low Dose CT scan of the Chest (without contrast) and the new Medicare Item Number 57410, which will designate the initial scan. The imaging request will state that the patient’s eligibility to participate in the National Lung Cancer Screening Program has been assessed and confirmed.
• An acquisition protocol for a Low Dose CT scan of the Chest (without contrast) and the new Medicare Item Number 57413, will designate any follow up / interval scans. The service is performed as a clinical follow-up within 2 years of a screening low-dose CT scan.

The recommended CT Dose as outlined by the Medicare Benefits Schedule is:

A LDCT with a volumetric CT dose index (CTDIvol) of ≤3.0 mGy (milligray) for a standard size patient (defined to be 170 cm and approximately 70 kg) with appropriate reductions in CTDIvol for smaller patients and appropriate increases in CTDIvol for larger patients. The National Lung Cancer Screening Program in conjunction with the Royal Australian and New Zealand  College of Radiologists and the Australian and New Zealand Society of Thoracic Radiology have released their LDCT Acquisition Guidelines.

Within those guidelines, there is reference to the American Association of Physicists in Medicine’s (AAPM) Lung Cancer Screening CT Protocols Version 6.0.

This document provides a technical reference guide for LDCT scanning for all makes and models from the CT scanning range of Canon Medical Systems, General Electric Healthcare, Philips and Siemens Healthineers.

It provides illustrative manufacturer-specific protocols and can be used to individually customise the majority of CT scanners in this country by linking the fixed imaging facility’s LSPN (which will have the specific make(s) and model(s) of CT scanner), to the NLCSP.

This can also be used as a basis of any key performance indicators which may be incorporated in any potential quality assurance program to ensure consistent radiation dose levels nationally.

The Australian National Lung Cancer Screening Program and its associated Registry will be one of the first of its kind to be established nationally in the world.

It will be unique for all clinical and medical stakeholders given the challenges and benefits of rolling out and then maintaining the program given the geographical diversity of the Australian population.

For further information, please contact, ASMIRT's Diagnostic Imaging Project Officer, Alan Malbon (Alan.Malbon@asmirt.org).