Rationale for the Nodule Management Protocol of the Australian National Lung Cancer Screening Program.

This article outlines how Australia’s forthcoming National Lung Cancer Screening Program (NLCSP) has developed a tailored lung nodule management protocol for use with low‑dose CT screening in high‑risk, asymptomatic individuals.

Key elements described:

• Program framework:
  • Biennial (every 2 years) routine LDCT screening.
  • Application of the PanCan risk prediction model at baseline to quantify malignancy risk of detected nodules.
  • Use of the most recent Lung‑RADS version to guide reporting and management of follow‑up LDCT scans.
• Adaptation for the Australian setting:

  The authors explain how international evidence and tools (PanCan, Lung‑RADS) were combined and modified to produce a protocol suited to Australian practice patterns, population risk profiles, and health‑system structure.

• Rationale:

  The protocol aims to standardise reporting, reduce variation in nodule management, optimise early lung cancer detection, and minimise unnecessary investigations and associated harms.

Overall, the article is a methodological and policy‑oriented overview, describing the reasoning and process behind creating a bespoke, evidence‑based nodule management framework that operationalises MSAC’s recommendations for a national lung cancer screening program.