Review Article | Diagnosis and Early Detection of Lung Cancer: Present and Future Approaches

Lung cancer is the leading cause of cancer deaths worldwide, with most cases found late. This review summarizes evidence on lung cancer diagnostics, highlights findings from important screening trials, and discusses new technologies shaping future approaches. It describes recent advances like artificial intelligence, radiomics, and molecular biomarkers for early detection. The review compares diagnostic tools, addresses barriers to their use, and presents new results from recent trials and technologies. By highlighting innovations and contrasting them with current practices, it clarifies the evolving landscape and offers strategies to improve early diagnosis. The review used a comprehensive PubMed search with the terms: "lung cancer AND (screening OR early detection OR diagnosis OR biomarkers OR artificial intelligence OR radiomics)." It included articles from 2010 to April 2024. Only English articles focused on adult human studies were included. The review analyzed original research, systematic reviews, meta-analyses, and major screening trials. Twenty-eight articles met these criteria, including five major screening trials. Five themes are identified: Enhanced Endoscopic Diagnostics, Liquid Biopsy and Molecular Biomarkers, Artificial Intelligence and Radiomics, Novel Biomarkers, and Integrated Screening Approaches. Low-dose computed tomography (LDCT) trials such as National Lung Screening Trial (NLST), Dutch Belgian lung cancer screening trial (NELSON), UK Lung Cancer Screening Trial (UKLS), and Multicentric Italian Lung Detection (MILD) show mortality benefit, but barriers remain. New diagnostic approaches, including liquid biopsy, AI with radiomics, and volatile organic compound profiling, may help overcome these barriers and support current strategies. Keywords: lung cancer, early detection, screening, low-dose CT, liquid biopsy, artificial intelligence, radiomics, biomarkers.