Rapid Fire Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Real-world healthcare utilisation and costs in a lung cancer screening cohort: evidence from the Australian arm of the International Lung Screening Trial (146177)

David Goldsbury 1 2 , Henry Marshall 3 , Renee Manser 4 5 6 , Annette McWilliams 7 , Ian Yang 3 , Emily Stone 8 9 , Paul Fogarty 10 , Stephen Lam 11 12 , Sukhinder Atkar-Khattra 12 13 , Philip Haywood 2 14 , Julia Steinberg 1 2 , Alison Pearce 1 2 , Karen Canfell 15 , Kwun Fong 3 , Marianne Weber 15
  1. The Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, NSW, Australia
  2. Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
  3. University of Queensland Thoracic Research Centre and Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Qld, Australia
  4. Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  5. Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
  6. Department of Internal Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  7. Department of Respiratory Medicine, Fiona Stanley Hospital, Perth, WA, Australia
  8. Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital, School of Clinical Medicine UNSW, Sydney, NSW, Australia
  9. School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  10. Respiratory Department, Epworth Eastern Hospital, Melbourne, Victoria, Australia
  11. Department of Medicine, The University of British Columbia, Vancouver, Canada
  12. Basic and Translational Research, British Columbia Cancer Research Centre, Vancouver, Canada
  13. University of British Columbia, Vancouver, Canada
  14. Leeder Centre for Health Policy, Economics and Data, Sydney, NSW, Australia
  15. Cancer Elimination Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia

Background: Australia’s National Lung Cancer Screening Program commenced in 2025, supported by evidence from studies such as the International Lung Screening Trial (ILST). This analysis describes patterns of healthcare utilisation and costs among participants in the Australian arm of the ILST.

Methods: Participants aged 55-80 years were recruited 2017-2019 and underwent two low-dose CT lung screening scans, two years apart. Baseline characteristics and screening results were linked to Medicare claims records from trial enrolment to February 2024. Health system costs and out-of-pocket costs were calculated for each participant over their follow-up period. Multivariable regression modelling examined associations between participant characteristics, screening findings, and subsequent costs.

Results: Among 1,164 participants with linked records, 55 (5%) had screen-detected lung cancer. Mean two-year health system costs were $28,195 for those with lung cancer and $6,804 for those without. Two-thirds of screening episodes identified additional findings, including emphysema and coronary artery calcification; these had mean health system costs approximately $1,400 higher than episodes without such findings. Higher overall costs were strongly associated with background healthcare use, including pre-existing medication use reported at baseline. Mean out-of-pocket costs increased with the number of additional findings.

Conclusions: Healthcare costs among screening participants varied according to screening outcomes and baseline healthcare use. In the absence of an unscreened comparator, these findings describe real-world cost patterns within a screened population and highlight key drivers of healthcare utilisation relevant to the implementation of Australia’s lung cancer screening program.