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Lung cancer screening — RACGP Fellowship MCQ

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HardPreventive health and screeningLung cancer screeningRACGP Fellowship

A 60‑year‑old man with a 35‑pack‑year smoking history asks about lung cancer screening after seeing an advertisement. He has no symptoms. He stopped smoking seven years ago and is anxious because his father had lung cancer. What is the most appropriate preventive measure?

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Correct answer: D — Assess eligibility for a structured low‑dose CT lung cancer screening program when available and provide smoking relapse prevention

He satisfies Australia's National Lung Cancer Screening Program eligibility: age 50–70 years, ≥30 pack‑years, quit within 10 years, asymptomatic. The evidence‑based screening method is low‑dose CT (biennially), supported by MBS item 57410. Smoking relapse prevention remains important. Chest X‑ray and sputum cytology lack screening efficacy; reassurance that risk is gone is incorrect—former smokers remain at elevated risk; bronchoscopy is diagnostic, not a screening tool.

Reference: Australian Government Department of Health – NLCSP eligibility criteria, May 2025, and workforce presentation Jan 2026; MBS Note IN.2.3 on screening referral, current. https://www9.health.gov.au/mbs/fullDisplay.cfm?criteria=lung+cancer&q=IN.2.3&qt=noteID&type=note