Lung cancer incorporated into National Cancer Screening Register

Lung cancer

By Michael Woodhead

25 Mar 2024

The National Cancer Screening Register has been expanded to incorporate lung cancer as part of the long-awaited program to develop a national screening program for high risk individuals.

Lung cancer becomes the third ‘designated cancer’ along with bowel and cervical cancer to be included in the coverage following the passing of the National Cancer Screening Register Amendment Bill 2024 (Bill) this month.

The amendments provide the legislative basis for the Register to collect, use, disclose and record information of participants  in the National Lung Cancer Screening Program (NLCSP) when it commences in July 2025 (link).

“By expanding the scope of the current operations of the Register to cover lung cancer screening, the Register will be able to generate advice and/or screening reminders for program participants and their nominated healthcare provider about when an individual is due to undergo lung cancer screening, or when an individual may need to take action after a lung cancer screening test, to support continuity of care,” the amendment notes.

“Expanding the scope of the Register will also support healthcare providers by providing them access to patients’ lung cancer screening information, for the purpose of providing healthcare, as well as enable program participants to access their lung cancer screening information in the Register.”

The impact assessment for adding lung cancer to the lung screening program concluded that there will be increased demand for the radiology workforce, particularly radiologists and radiographers undertaking the low-dose CT screening, interpreting the scan and reporting to the Register.

“Clinicians involved in the treatment of lung cancer are expected to experience an increase in demand,” it noted.

“The Program will not identify more people with cancer as those identified with cancer will have needed treatment in the longer term anyway, regardless of the stage of intervention. However, in the initial years, the Program will identify the prevalent, currently undiagnosed cases of lung cancer at all stages in the eligible cohort. It is difficult to estimate this impact on clinicians given some of these cases may now present at an earlier stage where their disease is less complex and more amenable to treatment.”

The move was welcomed by medical professional groups including the Lung Foundation and the RACGP.

“This is a smart public health decision,” said RACGP President Dr Nicole Higgins.

“Lung cancer must be taken very seriously. In 2021, it was the most common cause of cancer death in Australia, in that year there were well over 8,000 lung cancer deaths. The National Cancer Screening Register is such an important asset because it invites and reminds eligible patients to get screened for cancers that could take their life. Many people are busy in their lives and have other things front of mind, so prompting them to get tested or screened can be the difference between finding a cancer in time or a terminal diagnosis.

“The register also creates a useful safety net by encouraging patients and their healthcare providers, including GPs, to take the next steps in terms of screening so that they stand the highest chance of a successful outcome. There is nothing anywhere else in the world quite like it. The register creates a national platform to underpin the Government’s approach to tackling bowel cancer, cervical cancer, and now, thankfully, lung cancer.”

However the RACGP warned there was an urgent need to improve the functionality and red tape of the National Cancer Screening Register in real world use to ensure it operates efficiently.

“The Government must urgently fix some problems concerning how the register integrates with existing general practice systems called clinical information systems, or CISs. There are issues relating to connectivity difficulties and delays, with the software only working sporadically, the last thing busy GPs and practice teams need,” said Dr Higgins.

“Also, the process for accessing the information we need during consults with patients is notoriously slow, limiting our ability to take full advantage of this register and do the best for our patients. So, we urge the Government to work with us and make sure the entire process is seamless and responsive for all GPs and practice teams across Australia.

“Moreover, let’s cut red tape. Many GPs are reluctant to complete time-consuming administrative work generated from the register system. If these processes are important, we should be funded to complete them, or they should be automated from within general practice CISs. We just don’t have that extra time to be tied up with this work, caring for our patients must come first.

She also urged the government to “strongly consider” the next step of adding breast screening programs to the register.

“We understand that breast cancer screening programs are administered by the states and territories; however, let’s find a solution so that this deadly cancer is incorporated too,” said Dr Higgins.

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