Lung Cancer Diagnosis: Where we are and where we will Go? Classical and Innovative Applications in the Diagnosis of Lung Cancer

Lung cancer is the leading cause of cancer death in both men and women and is the second most common type in both. It generally has a poor prognosis, with 75 percent of patients being diagnosed at an advanced stage. The diagnostic tools typically in use are insufficiently sensitive and do not allow for early disease detection. As a result, finding alternative ways of early and accurate lung cancer diagnosis is critical for successful management. CT imaging, sputum cytology, biopsy, and bronchoscopy are examples of traditional procedures that have been adjusted over time to improve sensitivity and accuracy. Lung biopsy is a reliable procedure performed to help define the treatment strategy for patients with lung cancer. The use of computed tomography (CT), EBUS, EUS and bronchoscopy allowed the collection of specimens for a greater number of patients through minimally invasive procedures. The recent advances in molecular technologies and analytic platforms have made it possible to investigate the gene variations that contribute to tumorigenesis and become potential lung cancer biomarkers. Furthermore, liquid biopsies tend to be a safe alternative to traditional biopsies and can offer both accurate molecular data and a less invasive method of evaluating tumor activity, which could further improve the clinical management of lung cancer patients. This chapter provides an overview of the different traditional and emerging diagnostic tools for lung cancer. We need to understand the characteristics of these procedures that could have predictive, prognostic and therapeutic implications.