In Australia, thousands of people develop lung cancer every year. Lung cancer causes more deaths in both men and women than any of the other four commonly diagnosed cancers. Lung cancer disproportionately affects indigenous Australians, causes high levels of anxiety and distress and despite recent improvements in systemic therapies, still has a 5-year survival rate lower than the other four commonly diagnosed cancers. World-leading tobacco control, historically low smoking rates and advances in systemic therapy have all helped lower the impact of lung cancer. Australia will start lung cancer screening (LCS) with low dose CT Chest (LDCT) for high-risk, tobacco-exposed individuals in less than two years. This may reduce mortality in high-risk candidates by 20% or more, shifting the diagnosis from advanced to early-stage curable disease. International programs will inform the best implementation of LCS in Australia. The United States, first to introduce LCS nationally, struggles to reach 5% of eligible candidates. Pilot programs in the United Kingdom, with very different approaches, have reached over 50% of eligible candidates. Taiwan has evaluated LDCT in candidates who have never smoked, at risk primarily due to family history of lung cancer. To succeed in Australia, LCS will need to reach high-risk groups, integrate smoking cessation, effectively involve primary care practitioners, deal appropriately with additional findings on scans and direct patients rapidly to high-quality multidisciplinary care. The current workforce, including specialist nursing, diagnostic clinicians and surgery, will need to expand. LCS in Australia presents a remarkable opportunity to transform lung cancer from the leading cause of cancer death to early-stage disease with potential for cure.