American Association for Bronchology and Interventional Pulmonology (AABIP) Evidence-Based Guidelines on Bronchoscopic Diagnosis and Staging of Lung Cancer
Recommended Citation
Miller RJ, Chrissian AA, Kheir F, Shafiq M, Chua AT, Navani N, Almeida FA, Alraiyes AH, Bain PA, Bellinger CR, Chao CH, Cheng GZ, Cloyes R, Diaz-Mendoza J, DiBardino DM, Folch E, Frye LK, Gesthalter YB, Gildea TR, Goyal A, Heskett KM, Holden VK, Liberman M, Manley C, Meena NK, Oberg CL, Pannu JK, Pickering EM, Senitko M, Shepard JO, Vandemoortele T, Mehta AC, and Yasufuku K. American Association for Bronchology and Interventional Pulmonology (AABIP) Evidence-Based Guidelines on Bronchoscopic Diagnosis and Staging of Lung Cancer. J Bronchology Interv Pulmonol 2025;32(4).
Document Type
Article
Publication Date
10-1-2025
Publication Title
J Bronchology Interv Pulmonol
Abstract
BACKGROUND: Lung cancer remains a predominant cause of cancer-related deaths worldwide, and there are notable geographic and institutional differences in both diagnostic and staging approaches. To address this, the American Association for Bronchology and Interventional Pulmonology (AABIP) convened a multidisciplinary committee to craft evidence-based and evidence-informed recommendations for diagnosing peripheral pulmonary nodules and performing convex probe endobronchial ultrasound (CP-EBUS)-guided mediastinal staging.
METHODS: A modified Delphi method guided the creation and refinement of 9 Population, Intervention, Comparator, Outcome (PICO) questions. A systematic literature review, updated through March 2023, served as the basis for drafting recommendations. The panel used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence and relied on National Institute for Health and Care Excellence (NICE) language to express the strength of each recommendation. Where suitable, meta-analyses were completed; otherwise, systematic reviews and consensus among experts provided the evidence for guidance.
RESULTS: Nine recommendations were ultimately proposed: 6 were supported by meta-analyses and 3 by systematic reviews. The topics include comparing diagnostic yield and complication rates between peripheral bronchoscopy and transthoracic needle biopsy, the use of multiple biopsy instruments and the role of rapid on-site evaluation (ROSE) during peripheral bronchoscopy, and best practices for CP-EBUS-guided mediastinal staging. Several critical considerations emerged, such as lesion size, evolving technologies in bronchoscopy, and the importance of both available resources and local expertise.
CONCLUSION: These guidelines aim to standardize and streamline recommendations for the bronchoscopic diagnosis and staging of lung cancer. Since rapid technological progress and observational data play significant roles in this field, ongoing research and evidence updates will be vital to refining best practices. Clinicians are advised to tailor these recommendations according to local circumstances, the unique needs of their patients, and any new findings as they develop.
Medical Subject Headings
Humans; Bronchoscopy; Lung Neoplasms; Neoplasm Staging; Evidence-Based Medicine; Pulmonary Medicine; Endosonography; United States; Societies; Medical; Delphi Technique
PubMed ID
41024606
Volume
32
Issue
4
