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). While genomic testing of lung cancer has been performed in other studies, testing other sites within the lung as well as peripheral blood for these biomarkers has not been attempted. The DEAMP cohort is unique for several reasons. The DECAMP cohort is the only cohort that specifically enrolls military personnel and offers the potential to identify mutations that might be linked to military specific exposures. It is also one of the most comprehensive and detailed cohorts associated with bronchoscopic brushings and tissue matched with CT imaging, clinical history in a longitudinal cohort.