Bronchoscopy in the diagnosis of lung cancer:: an evaluation of current practice.

Introduction Bronchoscopy is frequently practised by respiratory physicians, particularly when there is a suspicion of lung cancer. However, few guidelines are available and practice varies widely. Background Studies of current practice are few and unstandardised. Few data are available regarding equipment or procedure (information, prior investigations, environment, standardised reporting etc.). The evaluation of new techniques such as endobronchial ultrasound, autofluorescence bronchoscopy, transbronchial needle aspiration (TBNA) has been covered in recent publications. These evaluations are often undertaken without rigourous methodology (retrospective studies) but underline the feasibility of these techniques. Some, especially TBNA are nevertheless underused in practice. In the published studies evaluating practice the results of these investigations are often similar to those obtained in clinical trials even if a learning period is necessary. Complications are rare. Few studies of cost effectiveness are available but they support the use of these new techniques. Viewpoint A national study under the aegis of the SLPF (French Respiratory Society) is necessary to obtain comprehensive and reliable data on the practice of bronchoscopy in the investigation of lung cancer. Conclusions Studies evaluating current practices are few and unstandardised, and probably give only a partial survey of the success achieved and the difficulties encountered by respiratory physicians in their clinical routine.