Lung cancer

National lung cancer screening program wins MSAC approval


A national lung cancer screening program is a step closer to becoming a reality after receiving the backing of the Medical Services Advisory Committee.

The recommendation has been welcomed by federal Minister for Health Mark Butler, who promised to consider the advice on Thursday but declined to commit to any funding.

“I thank Cancer Australia for its work to date on a national lung cancer screening program,” he told the media.

“MSAC has carefully considered the details of this application which I am grateful for. The Albanese Government will consider the advice and respond in due course.”

Under the proposed scheme, screening will be available for patients aged 50-70, who have a history of cigarette smoking of at least 30 pack-years.

If former smokers, they will need to have quit within the previous decade. The screening, conducted via low-dose CT scans, will be available every two years.

“MSAC advised that there was high certainty clinical evidence that the proposed Program would lead to a reduction in lung cancer mortality,” it said in its final report published overnight.

The committee went on to say the defined eligibility criteria “produced an acceptable and robust incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained of approximately $65,000”.

This was “as well as optimising the consequences for lung cancer deaths avoided, overdiagnoses, false positive diagnoses and total net cost to the Australian Government health budget”.

Lung Foundation Australia CEO Mark Brooke said the report was a “positive first step” and urged the government to accept the recommendation without delay.

He said the introduction of a screening program would bring lung cancer prevention in line with other leading malignancies including bowel, cervical and breast cancers, all of which had a significantly higher five-year survival rate than lung cancer.

“It is critical that momentum is not lost on this life-saving initiative,” Mr Brooke added.

“We’re calling on the government to fast track a budget investment in site-specific pilots to ensure as many Australian lives are saved as possible.”

It comes after MSAC, which provides independent advice to government on all new Medicare items, earlier declined to recommend a scheme, citing a lack of certainty on costs at its March-April meeting.

It also requested an “investigation” of the eligibility criteria or screening intervals could be adjusted to reduce costs.

However, these concerns had all been resolved when the matter came up to be reconsidered in July, the committee said.

This was done by reducing the assumed uptake from 100% to 65% and taking into account the costs and consequences of novel immunotherapies and targeted therapies, according to the report.

Evidence supporting the clinical effectiveness of the program was based on nine RCTs, including the large National Lung Screening Trial [NLST] started in 20021 and NELSON trial started in 2003, comprising a total of 90,000 participants.

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