BOOST: A new pathway with BronchOscopic or Oesophageal ultrasound for lung cancer diagnosis and STaging

INTERVENTION: Control arm: bronchoscopy, CT guided lung biopsy, PET scan, mediastinoscopy Active arm: endobronchial or endoscopic ultrasound (EUS or EBUS, respectively) Follow‐up is for one year for all participants. CONDITION: Lung cancer ; Cancer ; Lung cancer PRIMARY OUTCOME: Time from first outpatient appointment to decision to treat. ; ; Information for the endpoints will be collected prospectively as patients go through the diagnostic and staging process and case report forms (CRFs) will be updated weekly. The information will be obtained from multi‐disciplinary team meetings (MDTs), patient notes and electronic patient records. SECONDARY OUTCOME: 1. The health care costs of diagnosing and staging lung cancer; 2. The number of tests and outpatient visits a patient requires to be diagnosed and staged with lung cancer; 3. The proportion of lung cancer patients that are diagnosed and staged with a single test after CT scan; 4. The time from first outpatient appointment to treatment; 5. The number of futile thoracotomies; ; Information for the endpoints will be collected prospectively as patients go through the diagnostic and staging process and case report forms (CRFs) will be updated weekly. The information will be obtained from multi‐disciplinary team meetings (MDTs), patient notes and electronic patient records. INCLUSION CRITERIA: 1. Aged greater than 18 years, either sex 2. Consecutive patients suspected of lung cancer on CT scan 3. Written informed consent 4. Able to tolerate fibre‐optic bronchoscopy