Abstract
Lung cancer is Australia’s leading cause of cancer death, claiming around 9,000 lives annually — roughly one every hour. The burden falls disproportionately on North Queensland, where remoteness, high smoking prevalence and a large First Nations population contribute to late-stage presentation and reduced survival. The Optimal Care Pathway (OCP) prioritises earlier detection and timely diagnosis; translating this into a geographically dispersed regional service demands deliberate redesign.
This presentation describes the Townsville Hospital and Health Service (THHS) approach across three linked components: population screening, early detection and rapid access nodule assessment. The National Lung Cancer Screening Program (NLCSP), commenced July 2025, provides the framework for systematic identification of high-risk individuals through biennial low-dose CT. In its first year the program screened almost 100,000 Australians, with First Nations people comprising more than 5% of participants; screening detects up to 70% of lung cancers, of which more than 65% are successfully treated when found early. THHS is developing a First Nations screening satellite, partnering with the Townsville Aboriginal and Islander Health Service and North West HHS to extend equitable access to historically under-served communities.
To prevent screen-detected and incidental pulmonary nodules stalling in conventional referral queues, a Rapid Access Lung Nodule Clinic (RALNC) is being established, applying standardised risk stratification, protocolised surveillance and streamlined access to interventional diagnostics including EBUS-TBNA. The objective is to align local practice with OCP timeframes — first specialist review within two weeks of referral and diagnosis completed within two weeks thereafter.
Key enablers include First Nations co-design, multidisciplinary coordination and dedicated clinical leadership; the principal barriers are workforce capacity and sustainable funding. The THHS model offers a transferable blueprint for embedding the lung cancer OCP across regional and remote Australia, with early detection and rapid nodule assessment as the foundation for improved survival and reduced disparity.