Mark Butler (Hindmarsh, Australian Labor Party, Minister for Health and Aged Care) Share this | Link to this | Hansard source

I move:

That this bill be now read a second time.

The need for this National Cancer Screening Register Amendment Bill 2024 arose from our federal budget last year and the announcement 'Tackling smoking and vaping, and improving cancer outcomes'.

Under this measure, the government announced a $263.8 million investment for a new National Lung Cancer Screening Program commencing in July 2025 to support earlier detection of lung cancer, when treatment is likely to be more effective. Part of this allocation includes expansion of the National Cancer Screening Register to support delivery of the new program.

While advances have been made in the diagnosis, treatment and care of people with lung cancer, it is still the leading cause of cancer-related deaths in this country.

Compared to most other cancers, the survival rate of people with lung cancer is poor. On average, only two in 10 people diagnosed with lung cancer survive five years after diagnosis, compared to a five-year relative survival rate of more than seven in 10 for all cancers combined.

Indigenous Australians are twice as likely to be diagnosed with lung cancer compared to non-Indigenous Australians.

They are also twice as likely to die from lung cancer compared to the general population.

In addition to Indigenous Australians, people living in remote, very remote areas and areas of greatest socioeconomic disadvantage are disproportionately affected by lung cancer, with higher lung cancer incidence and mortality in these populations.

For many people, the impacts of long-term smoking have increased their risk of developing cancer and other health complications. This is why the government is taking action in line with the National Tobacco Strategy 2020-2030 through stronger legislation, enforcement, education and support to prevent the uptake of smoking and vaping, and to encourage people to quit.

The Public Health (Tobacco and Other Products) Act 2023, passed by the parliament last year, consolidated the existing Commonwealth tobacco control framework into one act. It modernised and simplified the existing provisions and allows us to introduce new measures to strengthen our response to smoking and to prevent the promotion of vaping and e-cigarettes. The introduction of reforms to protect Australians, particularly young people, from the emerging harms of vaping and nicotine dependence, is the next step.

At the same time, the government is focused on education and support. The 2023-24 budget included $63 million for public health information campaigns to discourage Australians from taking up vaping and smoking and to encourage more people to quit. A further $30 million was invested in support programs to help Australians quit.

These measures aim to address the significant threat to public health that is caused by cigarettes and vaping. We want to do everything we can to avoid people suffering from preventable lung cancer.

The good news is that, if lung cancer is detected at an earlier stage, it is more likely to be successfully treated, leading to better outcomes for individuals as well as the larger community.

The aim of the National Lung Cancer Screening Program is to reduce the burden of lung cancer in the community—including the incidence of the disease, morbidity from the disease, or mortality from it. The program will facilitate this by detecting lung cancer earlier than would be the case in the absence of screening, thereby improving health outcomes.

The program will target asymptomatic individuals aged 50 to 70 years with a history of cigarette smoking of at least 30 pack-years, and if an individual has a history of cigarette smoking, has quit within the past decade.

Through the program, eligible at-risk Australians will be able to get a lung scan every two years, as recommended by the independent Medical Services Advisory Committee, and follow-up scans if there are any findings.

A positive screening test identifies people who have an increased likelihood of having lung cancer and who require further investigation to determine whether they have the disease. Participants will be encouraged to screen regularly so signs of lung cancer can be detected early.

The new screening program is expected to prevent more than 500 lung cancer deaths every single year.

This bill will amend the National Cancer Screening Register Act 2016, which provides the legislative framework for the operation of the National Cancer Screening Register. Specifically, the bill adds 'lung cancer' to the definition of 'designated cancer' and as a result, expands the scope of our register.

The act established the National Cancer Screening Register as a register of information about screening associated with certain types of cancer for the purpose of supporting cancer screening programs. The register commenced operation in 2017.

The act was drafted in such a way that new cancer screening programs could be added to the scope of the register in the future through amendments to the definition of 'designated cancer'.

Currently, the designated cancers in the act are bowel cancer and cervical cancer to allow the register to support the National Bowel Cancer Screening Program and the National Cervical Screening Program.

Inclusion of lung cancer as a 'designated cancer' in the act will make the National Lung Cancer Screening Program the third cancer screening program delivered by the register.

The government recognises the opportunity to leverage the register to facilitate a national approach to lung cancer screening. Expansion of the scope of the register to the new program will enable a consolidated source of lung cancer screening information to be maintained and to be used to support the screening program.

The bill will provide the legislative basis for the register to deliver the program, including handling of program participants' personal and sensitive information in connection with lung cancer screening and diagnosis.

The bill will effectively expand the register's purposes that are already in place for the bowel and cervical screening programs to the new National Lung Cancer Screening Program.

For example, to support continuity of care the register will generate advice and screening reminders for program participants and their nominated healthcare provider about when an individual is due to undergo a lung scan. If required, reminders will prompt an individual to see their healthcare provider following a lung scan. Depending on the participant's risk profile, the provider may refer the participant for a follow-up lung scan.

The register will support healthcare providers by providing them access to patients' lung cancer screening information, for the purpose of providing healthcare.

Program participants will have access to their own lung cancer screening information in the register and be able to update their participation in the program, such as deferring their screening or opting out of the register.

As a repository of information about lung cancer screening and diagnoses, the register will support monitoring of the effectiveness, quality and safety of lung cancer screening to improve service delivery of the program.

There are other efficiencies that can be gained by building on the current functions of the register to support lung cancer screening. For example, the register already interoperates with GP clinical information systems to enable healthcare providers to provide data to the register, as well as access to screening information in the register to better inform clinical decision-making.

Importantly, adding lung cancer as a designated cancer will extend the limited authorisations and exceptions in the act to ensure that personal information is only collected, recorded, used or disclosed to or from the register for specific purposes.

It should be noted that, apart from these legislative protections and restrictions, the register operator is required to operate the register in accordance with strict security requirements. Through this bill, the existing identity and user access management solutions and security protocols will be expanded to lung cancer screening information that's held in the register.

The government is serious about increasing the number of Australians who participate in cancer screening as part of the national fight against cancer.

The National Lung Cancer Screening Program, in particular, is being designed to underpin the principles of access and equity. That is why a key element of the program includes two new Medicare Benefits Schedule items for lung cancer screening which will be available from July 2025 to enable scans to be delivered at no out-of-pocket cost to patients.

The National Lung Cancer Screening Program is being co-designed with and for First Nations people to ensure the program is culturally safe and appropriate, and mobile screening and patient travel support measures are in development to increase access to the program—including to support Australians in rural and remote locations with limited access to these services.

Other key activities underway to support the program include development of program guidelines, workforce education and training materials, a quality management framework and a national communications strategy.

While the program will impact our health system, it is not anticipated to increase the patient pool, but rather to reduce the current impact of treating advanced stage cancer patients and palliative care patients. The Department of Health and Aged Care continues to work with states and territories on implementation of the program.

Passage of this bill in the winter sitting will enable sufficient time to scale up the register, to undertake consultation with healthcare providers, build additional clinical software interface and deploy the register to support the National Lung Cancer Screening Program from July 2025.

I commend the bill to the House.

Debate adjourned.