A New Pathway With BronchOscopic or Oesophageal Ultrasound for Lung Cancer Diagnosis and STaging (BOOST)

A Randomized Controlled Trial of Endobronchial or Endoscopic Ultrasound as a First Test in the Diagnosis and Staging of Lung Cancer

In the UK, staging of lung cancer is time consuming (taking on average more than 3 weeks), costly and inaccurate in up to 20% of cases. The investigators wish to determine whether using the newer techniques of endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS) improves lung cancer staging. The investigators' hypothesis is that EUS (endoscopic ultrasound) or EBUS (endobronchial ultrasound guided transbronchial needle aspirate) as a first test after CT scan in the diagnosis and staging of lung cancer will result in a reduction in the time from first outpatient appointment to treatment decision, a reduction in the total number of scans and investigative operations, fewer outpatient attendances and a reduction in healthcare costs.

Inclusion Criteria:

• Consecutive patients suspected of lung cancer on CT scan
• Written informed consent
• Able to tolerate bronchoscopy and thoracic surgery

Exclusion Criteria:

• Evidence of severe or uncontrolled systemic disease that makes it undesirable for the patient to participate in the trial
• Any disorder making reliable informed consent impossible
• Patients with extra-thoracic disease, supraclavicular lymphadenopathy or pleural effusion