Target population 

The NLCSP is a screening program using low dose computed tomography (low-dose CT) scans to look for lung cancer in high-risk individuals (aged between 50 and 70 years) without any symptoms and targets: 

• Current and former smokers with chronic obstructive pulmonary disease (COPD/emphysema) 

• Patients with significant smoking history (typically 20+ pack years) 

• Those within the eligible age range as specified in the program guidelines 

Patients with COPD face substantially elevated lung cancer risk due to cumulative tobacco-related lung damage, making them a priority cohort for early detection. 

The evidence for screening 

Low-dose CT screening in high-risk populations has demonstrated mortality reduction of up to 20% in major international trials, including the US National Lung Screening Trial and the NELSON study in Europe. Early detection enables curative intervention before symptoms emerge, when treatment outcomes are significantly better. 

Lung cancer remains one of Australia’s leading causes of cancer death, predominantly due to late-stage diagnosis. Screening offers an evidence-based opportunity to shift detection earlier in the disease trajectory. 

Implementation in practice 

The screening process involves low-dose CT chest scans – quick, non-invasive imaging that can be completed in minutes. Practices should consider: 

• Reviewing patient lists to identify those meeting eligibility criteria 

• Raising screening during routine COPD reviews and respiratory consultations 

• Discussing the program during smoking cessation conversations with current and former smokers 

• Incorporating screening discussions into health assessments for eligible age groups 

Program resources 

Detailed eligibility criteria, referral pathways, and patient information resources are available through Cancer Australia. The information packs sent to practices include decision-support tools to assist with patient conversations about screening benefits and limitations. 

Clinical considerations 

As with any screening program, shared decision-making is essential. Patients should understand both the potential benefits (early cancer detection) and considerations (false positives, anxiety, radiation exposure from CT). The program materials include resources to support these conversations. 

For patients with COPD who meet eligibility criteria, lung cancer screening represents an important secondary prevention strategy alongside smoking cessation support and optimal COPD management. 


Further information: Cancer Australia – www.canceraustralia.gov.au