The Curtin University validation study in Occupational and Environmental Medicine exposes a systemic flaw in Australia's emerging national lung cancer screening program: asbestos history is sidelined in favor of smoking-centric models like the PLCOm2012 risk calculator. This observational analysis of the Western Australia Asbestos Review Program (no RCT design, sample drawn from occupationally exposed cohorts) demonstrates poor calibration of standard predictions for asbestos-exposed individuals, where latency periods of 20-40 years amplify risk independently of tobacco use. Sample limitations include reliance on self-reported occupational histories without biomarker validation, and no declared conflicts beyond academic affiliations. Building on the 2011 National Lung Screening Trial (NLST, RCT with 53,454 participants showing 20% mortality reduction via LDCT) and the 2019 NELSON trial (RCT, 15,792 participants), which both underrepresented non-smoking asbestos cohorts, the Curtin work reveals how these trials' eligibility criteria create blind spots. Real-world data from Australia's asbestos legacy in construction and mining suggest thousands could benefit from expanded criteria incorporating cumulative fiber exposure metrics, yet mainstream coverage fixates on AI-enhanced imaging rather than protocol reform. This omission risks late-stage diagnoses in a population already burdened by mesothelioma overlap.