Nurses are being encouraged to learn more about the new national lung cancer screening program (NLCSP), the first national screening program to be launched in two decades. Beginning in July, it marks a significant development in lung cancer detection, with hopes it will save 12,000 lives over the next decade.
Early detection of lung malignancy is critical to addressing cancer deaths: as it stands, lung cancer is the fifth most diagnosed type of cancer in Australia, with the chance of surviving five years after diagnosis only 26 per cent. It is the most common cause of cancer death (AIHW 2024). The launch of the NLCSP is a major achievement for Lung Foundation Australia, which has spent more than 10 years lobbying for it in the face of challenges including cost and accuracy. Lung cancer screening is now expanding globally, with programs run in Canada, the US and parts of Europe.
The NLCSP targets high-risk individuals: those aged between 50 and 70 years old, who are asymptomatic, current smokers or who have quit within 10 years, with a smoking history of 30 pack years (see box below). It is worth understanding that patients with symptoms suspected of having lung cancer should be investigated per the latest guidelines (Cancer Australia 2020). Those eligible for screening, however, will be referred for low-dose CT scans designed to detect lung nodules and early-stage lung cancers, which can pick up cancer earlier than chest X-rays. The program is expected to lead to the diagnosis of about 70 per cent of cancer cases at early stages, when treatment options are most effective.
Pack years
A pack year is a way of measuring how much someone has smoked.
One ‘pack year’ is equivalent to smoking 20 cigarettes a day (a ‘pack’) for a year.
So, someone who has smoked 10 cigarettes (half a pack) a day for 20 years has smoked for 10 pack years.”
Someone who has smoked 20 cigarettes a day (one pack) for 20 years has smoked for 20 pack years.
While someone who has smoked 40 cigarettes a day (two packs) for 20 years has smoked for 40 pack years.
Nurse practitioners are authorised to request low-dose CT scans under the program, via new MBS items 57410 and 57413, and attract the same rebate as other practitioners.
The organisation’s Chief Nurse and Lung Cancer Program Manager, Nicole Parkinson, says primary care nurses could play a health promotion role by identifying patients on clinic lists who are likely to be eligible for screening and contacting them to encourage them to make an appointment to discuss screening further with their GP.
She says stigma remains a major barrier to people seeking screening for lung cancer, as they may feel unworthy of treatment or fear what might be discovered.
“[Stigma is] still almost as prominent as it ever has been,” says Ms Parkinson, “Anybody that has lung cancer, a number of patients that I’ve spoken to over the years, will say that they’ll have conversations with family, friends, health professionals. And the first question many people ask is, “were you a smoker?”, and with that comes self-blame.”
Nurses can also play a valuable role in supporting lung health through patient education, symptom awareness, and smoking cessation support, says Ms Parkinson.
“The evidence does show that it can take up to 20 brief interventions or conversations with a patient for them to sometimes even consider stopping. So the more that nurses can actually have those brief interventions, asking, advising, assisting with smoking cessation [the more that is] going to help in that promotion of lung health.”
Lung Foundation Australia will soon launch a nurse-led helpline to support patients throughout their screening journey. This addresses the psychological burden of routine monitoring, particularly for those with nodules requiring follow-up scans over up to two years.
Lung Foundation Australia’s 12 specialist lung cancer nurses are pioneering innovative models of care, including nurse-led pulmonary nodule assessment clinics, pre-multidisciplinary team assessment services, and survivorship clinics. These positions, funded through federal and state partnerships, demonstrate the vital role nurses play in streamlining the diagnostic pathway.
As the program evolves, there’s hope that the eligibility criteria may expand to include non-smokers and those over 70. For now, it’s an opportunity for nurses to familiarise themselves with the program criteria and pathways, positioning themselves as advocates for early detection and lung health promotion.
Ask, Advise, Help
We know that smoking is a modifiable risk factor for a range of diseases, but often it is hard to broach the topic with patients. Here is a guide on supporting patients on their quitting journey from Quit Centre:
Quit’s 3-step brief advice model, Ask, Advise, Help (AAH) focuses on identifying patients who smoke and connecting them to evidence-based tobacco dependence treatment: multi-session behavioural intervention through Quitline and approved pharmacotherapy.
If clinically appropriate:
Ask all patients about smoking status and document this in their medical record.
Advise all patients who smoke to quit in a clear, non-confrontational and personalised way, and advise of the best way to quit. The best way to quit is to combine brief advice from a primary care nurse with behavioural intervention (such as Quitline), and pharmacotherapy as clinically appropriate. Behavioural intervention helps people to identify their triggers for smoking and/or vaping, develop practical strategies and shift their self-identify from someone who smokes or vapes to someone who doesn’t. Pharmacotherapy helps to reduce cravings and withdrawal symptoms.
Help by offering all patients who smoke an opt-out referral to behavioural intervention through Quitline (13 7848), and by prescribing (or helping patients to access) approved pharmacotherapy, such as nicotine replacement therapy.
Taken from Quit Centre for health professionals
While you may not get them to quit then and there, you are potentially playing a role in their journey towards making that vital health decision.
For more information about the National Lung Cancer Screening Program, visit the Australian Government Department of Health, Disability and Ageing website.
Author: Lexi Metherell MACN
ACN Senior Media Adviser
References
Cancer Australia (2024). Lung cancer in Australia statistics, https://www.canceraustralia.gov.au/cancer-types/lung-cancer/lung-cancer-australia-statistics, accessed 23 June 2025
Cancer Australia (2020), Investigating symptoms of lung cancer. A guide for all health professionals May 2020, https://www.canceraustralia.gov.au/sites/default/files/2025-04/investigating-symptoms-of-lung-cancer-islc-guide-updated-for-nlcsp-10-jul-2024.PDF, accesses 23 June 2025
