450,000 Australians may benefit from lung cancer screening

Lung cancer

27 Jun 2016

Some 450,000 Australians may be eligible for lung cancer screening – but researchers say there is a long way to go before a national screening program becomes a reality.

In a study published in this week’s Medical Journal of Australia, Perth researchers led by Dr David Manners of Sir Charles Gairdner Hospital and researchers at Busselton Population Medical Research Institute analysed 3586 adults to determine the proportion who could be eligible for screening for lung cancer.

“Our study suggests that 17.9% to 20.1% of current or former smokers aged 55–68 years in Busselton would be eligible for lung cancer screening”, depending on which criteria are applied, the authors wrote.

“This is equivalent to 8.9–10.0% of the total population aged 55–68 years, which suggests about 450,000 individuals in Australia may be eligible for lung cancer screening,” they wrote.

Co-author, Associate Professor Fraser Brims said this was the first time an estimate had been made in Australia, even though screening is already being widely used in the US. However, he said more research and modelling needed to be done in Australia to put a case forward for screening to be funded.

“This is just a part of the puzzle, it’s a first step forward,” he told the limbic. “It’s really exciting but we have to do it properly and carefully.

“Medicare does not currently provide benefits for lung cancer screening. We need to identify which models work best and when we know that we might be in a better position to persuade Medicare.”

Professor Brims said screening for lung cancer was complex and could not be compared with screening programs for breast, bowel and cervical cancer, and cautioned against using CT scanning to determine risk.

“More than half of current or ex-smokers will have something wrong in that CT scan,” he said.

But it was unlikely to be cancer, leading to unnecessary and sometimes invasive testing. Without protocols there was also a high risk of false positives and false negatives.

“We should not be doing ad-hoc screening on our patients, because we risk doing more harm than good,” he said.

He said a national study would soon start to establish a protocol for identifying and screening people at risk of lung cancer. The overall aim is to establish a national lung screening program for early detection, although this could be realistically two-four years away.

The researchers also found that spirometry, which requires direct patient contact, was unlikely to significantly improve the identification of individuals who should be screened for lung cancer.

“Defining COPD on the basis of symptoms is [however] an appropriate surrogate measure for spirometry”, they wrote.

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