Cancer

Aboriginal and Torres Strait Islander peoples should define safety, benefit and sovereignty in precision cancer medicine research for their communities

Justine R Clark (Adnyamathanha) · Jessica Buck (Kamilaroi) · Amanda Richards‐Satour (Adnyamathanha and Barngarla) · Louise Lyons (Jaadwa) · Alex Brown (Yuin)

Addressing the ethical implications helps physician and patient engagement with AI in supportive cancer care

Ian N Olver

Thanks to the families’ willingness to donate tissues of their child’s tumour, new clinical trials are exploring novel therapies for the treatment of DIPG

Santosh Valvi · Neevika Manoharan · Marion K Mateos · Timothy EG Hassall · David S Ziegler · Geoffrey B McCowage · Matthew D Dun · David D Eisenstat · Nicholas G Gottardo · Jordan R Hansford

Enhancing symptomatic cancer diagnosis requires GP-appropriate guidelines and tools that reflect a generalist approach to diagnosis

Brent Venning · Jon D Emery

A 75-year-old man presented with three days of lethargy and diarrhoea

Noor Lammoza · Maria Hormiz · Cherie Chiang · Chris Stead · Mustafa Ayhan · Samuel C Hume

A 64-year-old woman presented with non-neutropenic fever and back pain one day after the first cycle of neoadjuvant chemotherapy

Luigi Zolio · Prudence A Francis · Nava Ferdowsi

The treatment of colorectal cancer has evolved dramatically in the 21st century, particularly for patients with advanced disease

Kilian GM Brown · Nabila Ansari · Michael J Solomon

The Australian Cancer Plan is a landmark national policy reform to achieve equity of cancer outcomes and experiences for all Australians

Daniel Chaji · Anna Boltong · Carolyn Der Vartanian · Adam Lambert · Cindy Toms · Vivienne Milch · Claire Howlett · Dorothy Keefe

A 56-year-old woman of European ancestry from a suburban area of Far North Queensland was referred to the local cardiothoracic unit for a right lower lobe lung lesion

Sigrid G Theodore · Hannah J Sawkins · Manish Mathew · Sumit Yadav · Robert Norton

The study by Kou and colleagues provides support for the current Cancer Australia breast cancer treatment guidelines

Nicholas R Wilcken

Residential location does not markedly influence access to health services for Queenslanders with melanoma

Daniel Lindsay · David C Whiteman · Catherine M Olsen · Louisa G Gordon

Hepatocellular carcinoma is a leading cause of cancer-related death worldwide, and is increasing in incidence in Australia

Samuel Hui · Sally Bell · Suong Le · Anouk Dev

Robust evidence is needed for future mammography population screening practice and policy

Brooke Nickel · Nick Ormiston‐Smith · Lisa Hammerton · Erin Cvejic · Paul Vardon · Zoe Mcinally · Paula Legerton · Karen Baker · Jennifer Isautier · Emma Larsen · Michelle Giles · Meagan E Brennan · Kirsten J McCaffery · Nehmat Houssami

Findings support the treatment timeframes recommended as timely in the 2020 guidelines

Kou Kou · Joanne F Aitken · Christopher Pyke · Suzanne Chambers · Jeff Dunn · Peter D Baade

A commitment to culturally appropriate codesign processes will shape the development of an equitable lung cancer screening pathway

Alison Brown · Gail Garvey · Nicole M Rankin · Claire Nightingale · Lisa J Whop

To the Editor: The incidence of lung cancer and the five‐year survival of patients diagnosed with lung cancer reflect the social gradient within the Australian society. Most notably, Aboriginal and Torres Strait Islander people are twice as likely to develop lung cancer and half as likely to survive lung cancer.1 Reducing inequity in lung cancer outcomes was a key objective of Cancer Australia when it proposed a National Lung Cancer Screening Program (NLCSP) in 2020, following an enquiry that consulted both medical experts and the broader community.1 The Department of Health sought funding for Cancer Australia's proposed NLCSP in the 2021–2022 Budget but was required by the Department of Finance to refer the proposal to the Medical Services Advisory Committee (MSAC) for review.2 So, when MSAC recently announced its support for the creation of the NLCSP, there was great relief within the lung cancer community. However, what few people seemed to realise was that MSAC had in fact designed, then endorsed, their own alternative model for an NLCSP.3 MSAC's model is fundamentally different to Cancer Australia's model in terms of who is eligible to be screened and, therefore, who can benefit from the screening program. Whereas Cancer Australia intended using an individual's risk of lung cancer (as estimated by the PLCOm2012 risk calculator, which combines sociodemographic data and smoking history),4 MSAC recommended using fixed cut‐offs for age and smoking history. This is problematic in terms of both the evidence base that should have guided MSAC's decision and the ethical implications of the decision. MSAC's approach aligns with the design of historical lung cancer screening trials but it ignores an extensive body of evidence, including both a priori and post hoc analyses of trial data that consistently demonstrate that risk calculators are more efficient than fixed criteria.5 Furthermore, it also ignores international trends in the design of lung cancer screening trials and the implementation of lung cancer screening programs.1 But more importantly, the inevitable consequence of applying MSAC's eligibility criteria will be that fewer socially disadvantaged individuals will be eligible to participate in the NLCSP. This has the potential to exacerbate the existing inequity.

Jonathon B Ryan

Joshua M Inglis · Ganessan Kichenadasse · Arduino A Mangoni