Thousands of Australians who survived decades of asbestos exposure may be walking blindly into a late-stage lung cancer diagnosis because their occupational history isn't being tracked by the country's screening programs. Curtin University researchers have identified a critical gap that could cost lives: asbestos exposure—once a hallmark of Australia's construction, mining, and manufacturing sectors—is being ignored in the very screening criteria designed to catch lung cancer early.
The research, published in Occupational and Environmental Medicine and led by Curtin Medical School Ph.D. researcher Chellan Kumarasamy, validates what many public health experts have suspected for years. While Australia's lung cancer screening frameworks focus heavily on smoking history, they systematically overlook people with past asbestos exposure, leaving them unidentified and at severe disadvantage. "Asbestos exposure remains a major driver of lung cancer risk in Australia, yet it is not being properly accounted for in the screening criteria," Kumarasamy explained. "This represents a missed opportunity to detect cancer earlier and save lives."
The stakes are particularly high because lung cancer remains a leading cause of cancer death in Australia, with late diagnosis driving much of that mortality. When asbestos-exposed workers aren't flagged as high-risk candidates for screening, they often aren't diagnosed until symptoms appear—a point at which treatment options narrow dramatically and survival rates plummet. The problem is especially acute because so many Australians were exposed decades ago, during the country's industrial heyday, yet current screening frameworks simply don't account for their occupational histories.
Dr. Kim Betts, senior author from Curtin's School of Population Health, emphasized the scale of the oversight. "If we don't properly account for asbestos exposure, we risk leaving behind a group of Australians who would benefit most from early detection," she said. The researchers are calling for the national screening program to fundamentally rethink its approach: better occupational history tracking, more inclusive screening criteria that recognize asbestos as a major risk factor, and targeted action to identify people with past exposure before cancer takes hold.
What makes this finding particularly compelling is its simplicity. Australia has a documented legacy of asbestos use. Researchers know who is at risk. The tools to identify them exist. The missing piece is political and programmatic will—the decision to broaden screening criteria and invest in occupational history tracking that would flag thousands of at-risk Australians for earlier detection. Without that shift, the researchers warn that current patterns will continue: people diagnosed too late, when survival odds have already shifted against them, and a preventable tragedy masked by the assumption that they simply fell outside the risk profile.
The validation study, part of the Western Australia Asbestos Review Program, makes a straightforward case for reform. Asbestos exposure should be recognized in the design and implementation of Australia's national screening program. The cost of inaction—in lives and in late-stage treatment—may well outweigh the investment required to get it right.