Innovations in bronchoscopic techniques will go a long way for diagnosis of early-stage lung cancers

Lung cancer is one of the most common malignancies and a leading cause of cancer-related death worldwide (1). In China, the morbidity and mortality rates of lung cancer have been increasing over the past decades along with the worsening environment (2) and concerning situation of tobacco use (3). Imaging studies and sputum cytology as the conventional diagnostic approaches for lung cancer, are in fact very limited for detecting the early-stage lesions, and therefore do not help reduce the death toll. A number of clinical practice guidelines have recommended bronchoscopy as an important common tool for diagnosis of primary lung cancers (PLCs) (4). The direct vision of bronchoscopy enables brush and puncture biopsies, and performing bronchoalveolar lavage for cytological and histological diagnosis, which contributes to significant improvement in detection rate, and ultimately, to early identification, early diagnosis and early treatment of lung cancers. With the advance and refinement in molecular biology, endoscopic and imaging techniques, current practice with bronchoscopic examination has been recognized to remarkably enhance clinical diagnosis of lung cancer, and have an extraordinary role in improving the prognosis and survival rate of patients. This article reviews the use of several diagnostic modalities related to bronchoscopic techniques in individuals with high risk for lung cancers.