Aims: As Australia moves towards establishment of a National Lung Cancer Screening Program in 2025, understanding optimal eligibility criteria is warranted. Comparing the eligibility criteria and reach of the national and regional programs that currently exist internationally can provide insights into optimal criteria for Australia’s program. This study aimed to compare the eligibility criteria for a lung cancer screening program between countries and model the reach of each program.
Methods: Targeted searches were undertaken to identify countries that had implemented or are implementing a national or regional lung cancer screening program. For each jurisdiction, relevant program guidelines, position statements and policy documents were identified, and audits undertaken. Data were extracted on target groups, models of screening, access pathways, costs to participate, priority groups, evaluation and changes to the program since inception. For modelling eligibility, data were sourced at the jurisdiction level on population size, age range, and smoking statistics.
Results: Eight countries (73%) utilised pack years to measure smoking intensity, with four countries, including Australia, adopting 30 pack years as an eligibility requirement. The remaining programs utilised risk prediction models to determine eligibility. For most programs (n=7; 64%), entry to the program needs support or facilitation from a primary healthcare professional. Australia’s program includes strategies to promote a culturally safe program for Aboriginal and Torres Strait Islander peoples.
Conclusions: Australia’s lung cancer screening program has a higher pack years requirement and narrower age range than many other international screening programs. Entry to the Australian program will be facilitated by General Practitioners and there is a need to consider the management of at-risk groups who are not currently eligible to be screened. Expanding eligibility criteria for Australia’s program in future years could further reduce lung cancer deaths.