National Lung Cancer Screening Program information for healthcare providers

Healthcare provider roles

Healthcare providers play a central and critical role in the program, including:

• general practitioners and specialists
• practice nurses, nurse practitioners, registered nurses and enrolled nurses
• Aboriginal and Torres Strait Islander health workers and health practitioners
• practice managers and administrative staff
• health support workers in
  • health promotion
  • disability support
  • mental health support
• bicultural workers
• allied health professionals
• public and private radiology service providers
• respiratory physicians
• oncologists.

Workforce education and information

We have developed a set of resources for the program to help healthcare professionals and participants understand the program. These include materials such as fact sheets, brochures and videos; some are available in other languages.

These resources contain information on:

• the program background
• process
• results
• smoking cessation
• how to reduce stigma
• how to start a conversation about lung cancer screening.

A digital communication toolkit has also been developed to help you and your staff promote the program with your networks. The toolkit contains key messages, images and content for your social media, newsletters, emails and websites that can be used directly or adapted for your channels. In addition to this, we have updated the cancer screening GP engagement kits and are providing these to more than 7,000 GP practices.

eLearning modules

Program specific Continuing Professional Development accredited eLearning Modules have also been developed for the healthcare workforce. The training consists of 7 self-paced modules which will take approximately 3.5 hours in total to complete. Completion of this training will earn you 3.5 Continuing Professional Development points.

Modules cover:

• the status of lung cancer in Australia
• the overall program
• program recruitment and eligibility
• the low-dose CT scan, assessment and results
• effective communication strategies.

These modules are accredited by RACGP, APNA, NAATSIHWP and ACCRM and available on the Lung Foundation Australia’s Lung Learning Hub.

Radiology sector materials

The radiology workforce has a specific and significant technical role in delivering the program.

Cancer Australia commissioned the Royal Australian and New Zealand College of Radiologists (RANZCR) to develop a suite of radiology sector-specific information materials and accredited education training resources to support the radiology workforce. These resources include:

• Nodule Management Protocol: contains detailed guidance for radiologists around reporting lung nodule findings and providing appropriate management recommendations.
• Additional Findings Guidelines: provide definitions of common actionable additional findings, to maximise health outcomes for participants, while minimising harm and cost. Actionable additional findings are defined as additional findings, where there is clear opportunity (via further investigation, clinical management, or both) for an improved health outcome for the participant.
• Low-dose CT Acquisition Guidelines: provide technical information on how to perform low-dose CT scans for the program.
• Structured Clinical Radiology Report: details the fields and content that comprise the NLCSP Structured Clinical Radiology Report. It sets out the format that radiology departments must use to establish a structured reporting template in their own practice. Explanatory notes are included to guide radiologists on how to complete certain fields.
• RANZCR held webinars and workshops leading up to the start of the program. This supported the radiology sector to prepare for the program and RANZCR continues to implement training.

As the radiology workforce is an accredited and regulated workforce, there will be no further accreditation required to deliver the program.

We also provide updates to and seek feedback from our Diagnostic Imaging Stakeholder Committee. The committee provides a forum for diagnostic imaging stakeholders, including industry, clinicians, and consumer representatives. They share information and discuss issues related to diagnostic imaging and the diagnostic imaging sector, including:

• diagnostic imaging policy and regulatory issues relating to Medicare
• changes and trends in diagnostic imaging services.

Program guidelines

To support the delivery of the program, we worked with Cancer Australia and held public consultations to develop the National Lung Cancer Screening Program Guidelines. The guidelines help you:

• navigate the program with evidence-based recommendations along the screening pathway
• manage participants’ journeys through the screening program.

Cancer Australia commissioned the University of Melbourne to develop the guidelines in consultation with:

• experts
• clinicians
• researchers
• Aboriginal and Torres Strait Islander peoples
• members of the public.

The guidelines outline advice and recommendations based on existing evidence and materials. This includes the MSAC’s advice on a lung cancer screening program and assessment pathways.

The guidelines also include information on:

• steps of the screening and assessment pathway
• participant recruitment and eligibility
• how to provide smoking cessation advice and support
• the requirements for shared decision-making
• the processes for a low-dose CT request, scan, and assessment
• evidence-based recommendations and practice points
• links to other resources and materials that support the program.

Professional colleges and peak bodies are helping to prepare their sectors for the program launch. Their work includes developing specific materials that link to the program guidelines.

See our resources for healthcare providers.

Enrolling participants in the program

To enrol a person as a participant in the program, you, your staff, or delegate (a nurse or practice staff member) completes the National Cancer Screening Register’s (NCSR) eligibility and enrolment form. This only needs to be done once to enrol a person in the NCSR.

The eligibility and enrolment form is available through Clinical Information Systems (CIS), such as Best Practice, Medical Director and Communicare, that are integrated with the NCSR. The form is also available through the NCSR Healthcare Provider Portal. 

User guides on how to use the NCSR and the various NLCSP forms are available on the NCSR website.

Low-dose CT request form

The low-dose CT request form is a program specific imaging request form developed in consultation with general practice and radiologists. This form is available in Best Practice, Medical Director and MMEx and Communicare clinical software. The form is available online and as a tear-off pad in the GP cancer screening engagement kits mailed out to more than 7,000 practices.

Using this form means the radiology provider is aware the participant is in the program so that they:

• have the information they need, such as family history of lung cancer or previous NLCSP scans, to help them report the scan
• report the scan on the structured report template using the NLCSP Nodule Management Protocol
• know the patient needs to be bulk billed for the scan.

New MBS items for NLCSP low-dose CT scans

Two new Medicare Benefit Schedule (MBS) items have been created to provide low-dose CT scans under the program:

• MBS item 57410 – for the screening low-dose CT scan done by the participant approximately every 2 years
• MBS item 57413 – for any interval low-dose CT scans that may be required, depending on the results of previous scans.

These are mandatory bulk billing items and have mandatory reporting requirements.

Individuals can choose to opt-out of the NCSR and still have a free low-dose CT scan. However, they will not be considered a participant of the program or receive any communication from the NCSR. The radiology provider will still be able to receive the rebate from Medicare. The healthcare provider will be responsible for their screening.

The MBS website provides more information on these new items, including the item descriptors and explanatory notes.

In June 2024, the Expert Advisory Committee finalised the MBS item descriptions. This followed a consultation process between October 2023 to March 2024 with:

• the National Aboriginal Community Controlled Health Organisation (NACCHO)
• Cancer Australia
• professional colleges
• peak bodies
• the Expert Advisory Committee
• state and territory governments.

Screening costs

MSAC set the criteria for the NLCSP MBS items, including the MBS fee. The Medicare schedule fee for the 2 new MBS items is based on the schedule fee for MBS item 56301 and standard indexation will apply. The NLCSP MBS items are exempt from the 2024–25 Budget measure to amend the schedule fee for certain CT items. This means the program’s MBS rebate is higher than the general no contrast low-dose chest CT.

Radiology providers must bulk bill low-dose CT scans for the program when using the NLCSP MBS items above, meaning there is no out-of-pocket costs for the scan for participants.

Mandatory reporting

We have worked with the Royal Australian and New Zealand College of Radiologists (RANZCR) to develop a structured radiology reporting system. This will ensure a nationally standardised approach for radiologists to accurately and consistently report NLCSP low-dose CT scan results.

Reports for the person’s initial scan and their subsequent scans will be read and reported using the NLCSP Nodule Management Protocol. RANZCR and the Thoracic Society of Australia and New Zealand (TSANZ) worked in partnership to develop the protocol. It applies the recommendations made by MSAC and is derived from the:

• Pan-Canadian Early Detection of Lung Cancer (PanCan) risk calculator for reporting screening scans
• Lung CT Screening Reporting & Data System (Lung-RADS) for reporting interval scans.

Reporting initial scans

The program will use a modified version of the PanCan risk model for screening scans. This is the initial scan when entering the screening program.

PanCan is a risk assessment tool based on patient and nodule characteristics. It estimates the probability that a nodule from a low-dose CT scan is lung cancer.

We used clinical evidence and consultation to choose PanCan as the baseline nodule management model. It also has the highest sensitivity for baseline scans. PanCan has been internationally validated for use in baseline scans.

Reporting interval scans

The program uses a modified version of the Lung-RADS for interval scans. Lung-RADS is a quality assurance tool which standardises lexicon, interpretation, reporting and management of findings in lung cancer screening.

Lung-RADS helps nodule categorisation and will support you in considering the next steps.

You will request your patients with low and medium risk undergo more frequent monitoring and will refer patients with high and very high risk findings to a respiratory physician (or other specialist) linked to a lung cancer multidisciplinary team (MDT).

You can read more about the required nodule management system in MSAC’s March–April 2022 public summary document attachments.

We have worked with Cancer Australia and the radiology sector to ensure this reporting supports both the:

• clinical needs of the program
• mandatory requirement for radiology providers to report to the NSCR.

Reporting to the National Cancer Screening Register

The NCSR provides a single electronic record for each person in Australia participating in the Australian Government’s National Bowel Cancer Screening Program and National Cervical Screening Program. The National Cancer Screening Register Amendment (National Lung Cancer Screening Program) Rules 2025 that accompany the National Cancer Screening Register Act 2016 require radiologists to report NLCSP screening information to the NCSR.

Similar to the bowel and cervical screening programs, you will access information in the NCSR through the:

• Healthcare Provider home page
• Healthcare Provider Portal.

The NCSR provides information and helpful reminders about screening for both you and participants.

Find more information about what you and your patients can use the portal for.

You may access participant information and remind them if they need to take action for lung cancer screening.

To support the delivery of the program, the NCSR:

• supports the enrolment of participants in the National Lung Cancer Screening Program
• maintains a national database of lung screening records
• reminds participants (and their healthcare provider) when they are due or overdue for lung screening and when they need to take action after a scan
• provides participant lung cancer screening reports (not images) to
  • help radiologists in reporting/comparing low-dose CT scans
  • support you in recommending follow-up investigations
• enables participants to access their lung cancer screening information in the register, including updating their participation, such as changing their communication preferences
• monitors the effectiveness, quality and safety of lung cancer screening to improve delivery of the program.

The program guidelines, along with workforce education and information materials help you navigate and provide information to the NCSR.

An individual can choose to screen using the NLCSP MBS items and not be registered within the NCSR. However, these individuals will be considered external screeners (not program participants) and will not be captured in program reporting or receive reminders from the NCSR.

Integration with radiology information software providers

Radiologists will need to send a copy of the structured radiology report for the low-dose CT scan to the NCSR. The NCSR integration with Radiology Information Systems (RIS) is designed to streamline this process for radiologists and reports can be submitted via:

• Integrated RIS or Picture Archiving and Communication System (PACS)
• The Healthcare Provider Portal

We are working closely with the radiology sector and understand a significant portion of the private providers will integrate with the NCSR within the first 6 months of the program starting. The 6-month transition period means:

• participants are not affected by integration delays, as they have alternative reporting options
• all reports are captured for historical and evaluative purposes, which is crucial for participants' journeys and future evaluations of the NLCSP
• practices not yet integrated with the NCSR can submit reports manually until 31 December 2025.

For more information on radiology software integration, please visit the NCSR website.

Data collection and software providers

The Australian Government operates the NCSR under strict protocols to ensure all personal information is safe.

As part of developing the NCSR, we consulted with relevant stakeholders on the data that is collected for the program. Only data that supports a patient’s journey and program participation is collected. This data also helps:

• track the success of the program
• improve the delivery of the program to ensure better health outcomes.

The low-dose CT scans of program participants will not be stored in the NCSR. However, all state and territory governments are currently working together to develop national health information capabilities under the Intergovernmental Agreement on National Digital Health 2023–27. This will allow health professionals across different sectors to access key health information, including diagnostic images, about their patients in a timely way, regardless of where the information is stored.

The program does not require medical imaging providers to have any additional software to deliver the program.

MSAC recommendations

The Medical Services Advisory Committee (MSAC) considered the strength of the available evidence for the program related to:

• comparative safety and clinical effectiveness
• cost-effectiveness and total cost
• recommended the benefits of low-dose CT screening outweighing the potential harms for those meeting the eligibility criteria.

MSAC also recommended the use of nodule management protocols which can reduce the: 

• number of false positive findings
• subsequent need for additional invasive diagnostic procedures.

Read MSAC’s public summary documents explaining the outcomes of the decision-making process.

See our resources that provide healthcare providers and the general public with information and education materials to support participation in the program.

Contact