Lay summary
Lung cancer mortality is particularly high in NZ, with stark inequities adversely affecting Māori and Pasifika. As poor outcomes result from diagnosis at late stage, earlier detection would improve patient survival. While a national lung cancer screening programme would help achieve this, screening remains prone to errors with over- and underdiagnosis, and is limited by cost and accessibility. We aim to establish a truly national framework for collection and storage of patient samples, coupled with the development of a blood-based test looking at changes in DNA, to improve screening accuracy and cost-effectiveness. Our innovative strategy, combining DNA methylation and mutation analysis of circulating tumour DNA, will produce a test with increased accuracy. By testing peripheral blood at the point-of-care we will better serve rural NZ – essential for reducing health inequities. Earlier detection of lung cancers in our unique and diverse population will ensure equitable cancer outcomes for New Zealanders.