Role of bronchoscopy in early diagnosis of lung cancer

Lung cancer is a leading cause of cancer deaths and the incidence is rising. Most patients with lung cancer present to the clinician in a fairly advanced stage and at best only 25-30% of patients can be offered curative resection. Screening tests using sputum cytology and chest radiograph have been used with limited success. Value of low dose spiral CT scan as screening tool for lung cancer is being evaluated and its limitations include high costs, need for repeated scanning and necessity to obtain histological confirmation with additional procedures. There have been significant advances in the early diagnosis of lung cancer in high risk patient groups using bronchoscopic methods such as white light bronchoscopy, autofluorescence bronchoscopy, high magnification bronchoscopy, narrow band imaging and endobronchial ultrasound. These techniques appear to be promising tools as they might allow to visualise changes of early lung cancer and also permit sampling for histological confirmation.