Lung cancer screening: the program that doesn't send an invitation

Most cancer screening in Australia arrives in the post. A bowel screening kit turns up near a birthday. BreastScreen sends a reminder. It is easy to assume that if you were eligible for something, you would hear about it.

Lung cancer screening does not work that way.

The National Lung Cancer Screening Program commenced on 1 July 2025. The National Cancer Screening Register describes it as a targeted screening program, "meaning invitations to participate are not sent by default". Reminders follow once someone is enrolled — but getting enrolled starts with a conversation, not an envelope.

Who the program is for

The program is for people who have no signs or symptoms of lung cancer and who meet all of the following:

• aged between 50 and 70

• currently smoke tobacco cigarettes, or have quit within the past 10 years

• have a smoking history equivalent to a pack a day — around 20 cigarettes — for at least 30 years

That last criterion is the one that trips people up, because it is not simply "30 years of smoking". It is the combination of how much and how long, which is why it is usually written as 30 pack-years: two packs a day for 15 years counts too. The Register notes that practitioners are advised to use clinical judgement and best estimates when assessing smoking history, so an imperfect memory of exactly how much you smoked decades ago is not a barrier to asking.

What screening involves

Screening uses a low-dose CT scan — a chest scan that uses a lower radiation dose than a standard CT. The Department of Health, Disability and Ageing states that the scan is free through Medicare for eligible participants, and is repeated every two years unless something is found that needs following up sooner.

Under the program, a healthcare provider — a GP, a nurse practitioner, or a health worker at an Aboriginal Health Service — checks eligibility by asking about age and smoking history, and provides a program-specific referral form so the scan can be booked.

Why it matters

Lung cancer is often found at a late stage, when treatment is harder. The purpose of screening people at high risk who feel completely well is to find cancers earlier than symptoms would. Screening is not a substitute for stopping smoking, and it is not a test for people who already have symptoms. A new or changed cough, coughing up blood, breathlessness or unexplained weight loss should be looked at promptly, whatever your age or smoking history.

What to do next

If you are between 50 and 70 and you smoke, or you gave up within the last decade, raise it at your next appointment. Bring what you can remember about how much and how long you smoked — that is the information the eligibility check turns on.

Source: National Cancer Screening Register, "About the National Lung Cancer Screening Program", ncsr.gov.au. Australian Government Department of Health, Disability and Ageing, "National Lung Cancer Screening Program" and "How the National Lung Cancer Screening Program works", health.gov.au. Accessed 10 August 2026.