The goal of this project is to compare the efficacy of lung screening in community practice with that reported in the National Lung Screening Trial (NLST) with respect to the rate and type of abnormalities suspicious for lung cancer, the rate and type of significant incidental findings that are seen on lung screening and may be clinically important, but that are not related to lung cancer, and the diagnostic testing that is done to evaluate lung and other abnormalities.

The goal of this project is to understand the morbidity and mortality associated with detection of a significant incidental finding (SIF) on low-dose CT lung screening. SIF detection may be associated with early diagnosis of extra-pulmonary cancers and other conditions that benefit the patient or with the discovery of benign findings that generates unneeded and potentially harmful medical procedures. The results from this research will provide evidence for the development of practice guidelines to address SIFs detected at LDCT lung screening.

The Detection of Early Lung Cancer Among Military Personnel (DECAMP) consortium is conducting two multicenter prospective studies with the goals of developing an integrated panel of both airway and blood-based molecular biomarkers that discriminate benign and malignant indeterminate nodules detected on CT scan as well as predict the future development of lung cancer in high-risk individuals.

Currently several biomarkers are being validated on the DECAMP specimen, but none of these use the whole genome sequencing (WGS) technology. WGS offers a novel view of mutational changes in early lung cancer. We are testing for genomic biomarkers for the detection of early lung cancer using whole genome sequencing of DNA specimens from blood, endobronchial brushings and lung tumor specimens (for those with lung cancer).

The proposed work is to develop technology for both civil and military application. This subcontract involves providing expertise in developing statistical methodology. Key tasks to be performed by Dr.