Lung cancer screening has an asbestos blind spot, and it could be costing lives

Early detection saves lives, but asbestos exposure is being missed

On 1 July 2025, the Australian Government launched the National Lung Cancer Screening Program (NLCSP), a significant public health initiative designed to detect lung cancer earlier in people at higher risk, through free low-dose CT scans.

However, new research from Curtin University suggests there may be a gap in the program’s design, one that could mean people exposed to asbestos are not being identified as early as they should be.

As Maurice Blackburn’s Lung Clinical Nurse Consultant, Sara McLaughlin‑Barrett, explains:

“If we are serious about reducing lung cancer deaths, we can’t ignore occupational risk factors like asbestos exposure. Expanding screening eligibility to include these high‑risk groups is an essential next step to ensure the program delivers equitable and effective outcomes for all Australians.”

The road to the National Lung Cancer Screening Program

The NLCSP was years in the making. In August 2019, the Australian Government asked Cancer Australia to examine the feasibility, design, and delivery of a national lung cancer screening program. Its enquiry report, delivered in October 2020, provided a strong evidence base for lung cancer screening and outlined the most appropriate approach for Australia’s health system.

In October 2022, the Medical Services Advisory Committee (MSAC) supported the proposal, recommending screening for asymptomatic people aged 50 to 70 with a smoking history of at least 30 pack-years who currently smoke or have quit within the past 10 years.

The program officially commenced on 1 July 2025 and is expected to help prevent over 500 lung cancer deaths each year. Since its launch, it has already screened more than 56,000 Australians.

However, a recent study published in Occupational and Environmental Medicine has highlighted a concerning limitation. While the current screening criteria focus heavily on smoking history, they do not adequately account for past asbestos exposure.

Eligibility under the NLCSP is based on age and pack-year smoking history alone, with no consideration of asbestos or other occupational exposures, despite asbestos remaining a significant driver of lung cancer risk in Australia.

For people who worked in construction, manufacturing, mining, or other high‑risk industries decades ago, this blind spot could mean missing the opportunity for early diagnosis, when treatment options are broader and outcomes are often better.

“Every gap in the screening criteria represents a missed opportunity for early diagnosis,” says Sara McLaughlin‑Barrett. “By reviewing and expanding eligibility to include occupational asbestos exposure, we can detect more cancers earlier and significantly improve outcomes.”

Lung cancer is a malignant tumour that develops in one or both lungs, usually in the bronchi or the spongy lung tissue. It occurs when abnormal cells grow and multiply in an uncontrolled way, eventually forming a tumour that interferes with normal lung function[1].

Lung cancer is the leading cause of cancer‑related death in Australia, impacting thousands of families every year and significantly affecting quality of life.

Common symptoms include:

• shortness of breath
• persistent or recurring cough
• chest pain
• coughing or spitting up blood
• recurring chest infections
• hoarseness or changes to the voice
• fatigue, weight loss, or loss of appetite

In 2025, 15,108 Australians were diagnosed with lung cancer; tragically, approximately 60-65% of Australians diagnosed with lung cancer are diagnosed at a later stage[2].

Smoking isn’t the only cause of lung cancer

While smoking is a well‑known risk factor, it is not the only cause of lung cancer.

Workplace exposure to hazardous substances, including asbestos, silica dust, chemicals, fumes, and gases, significantly increases the risk of lung cancer. Occupational exposure alone is estimated to contribute to nearly 30% of lung cancer cases in Australian men[3].

Despite this, many people still believe lung cancer is only linked to smoking, contributing to stigma and misunderstanding around the disease.

Why asbestos exposure still matters

Asbestos is a naturally occurring mineral fibre that was widely used in Australian building materials until around 1985. It was commonly found in homes built after the Second World War, including in bathrooms, kitchens, cladding, and eaves.

Many people were exposed at work decades ago and may not realise that this exposure can still place them at increased risk today.

Research from Curtin University highlights that people with a history of asbestos exposure are often overlooked in lung cancer screening programs. Current approaches do not consistently capture occupational history or asbestos exposure when assessing risk.

When researchers tested Australia’s current screening criteria against a group of people with known asbestos exposure in Western Australia, the findings were stark. The criteria used for the national program identified just 8% of lung cancers. Nearly three‑quarters of the asbestos‑exposed group, including most of those who went on to develop lung cancer, would not have qualified for screening at all.

“We have an opportunity to save more lives,” says Sara McLaughlin‑Barrett, “but only if the screening criteria reflect the full picture of lung cancer risk. Expanding eligibility to include asbestos exposure is a necessary step to ensure high‑risk Australians aren’t left behind.”

The risks of overlooking asbestos exposure

Failing to account for asbestos exposure in lung cancer screening creates serious consequences. Because eligibility under the NLCSP is based solely on age and smoking history, people who were exposed to asbestos at work but never smoked, or who smoked less than 30 pack‑years, are excluded from the program entirely, despite remaining at elevated risk.

Without better recognition of occupational exposure, many of these individuals may not be identified until symptoms appear, when the disease is often more advanced, and treatment options are more limited.

Maurice Blackburn supports the researchers’ call for asbestos exposure to be recognised in the design and implementation of the national screening program. We continue to advocate for better‑calibrated risk models that properly account for occupational cohorts, so that people with known exposure are not left behind.

If you’re diagnosed, asbestos exposure still matters

Being diagnosed with lung cancer can be overwhelming. For people who have been exposed to asbestos, it’s important to understand that occupational exposure may still be relevant, even if you smoked in the past, are now retired, or your former employer no longer exists.

Compensation may still be available:

• if you previously smoked, you may still have an entitlement if asbestos or other workplace exposure contributed to your condition
• if your employer is no longer in business, a claim may still be possible through insurers or statutory bodies
• if you are retired, you may not be entitled to lost wages, but medical expenses, treatment costs, care, and pain and suffering damages may still be available depending on your circumstances

Support if asbestos exposure may have been overlooked

If lung cancer screening leads to a diagnosis and asbestos or silica exposure may be part of your work history, it’s important to understand what that means for you.

An asbestos‑related diagnosis can raise a lot of questions and uncertainty. Getting the right advice early can help you understand your options and access the support you may be entitled to.

We’re here to help

With decades of experience supporting Australians affected by occupational lung disease, our team is here to help. Our No Win, No Fee approach means you don’t pay our fees unless you win.

We also offer support beyond legal advice. Maurice Blackburn is the only law firm in Australia with a dedicated Lung Clinical Nurse Consultant to help answer health‑related questions and support you throughout your diagnosis and treatment.

Call 1800 111 222 for confidential advice, or to see whether you may have a claim.