RT Journal Article SR Electronic T1 Evolution in the diagnostic approach to lung cancer JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA3853 DO 10.1183/13993003.congress-2021.PA3853 VO 58 IS suppl 65 A1 Joana Da Silva Arana Fonseca Ribeiro A1 Gonçalo Samouco A1 Rebeca Martins Natal A1 Sara Braga A1 Filomena Luís A1 Luís Ferreira A1 Rita Matos Gomes A1 Luís Vaz Rodrigues YR 2021 UL http://erj.ersjournals.com/content/58/suppl_65/PA3853.abstract AB Introduction: Histological and molecular characterization remains a crucial step in the diagnosis of lung cancer (LC). Procedures for LC diagnosis vary according to tumor dimension, location and staging. Although significant achievements in the field of interventional pulmonology have been observed in recent years, there is still uncertainty on their reflection in clinical practice.Aims: To evaluate the evolution in the diagnostic approach to LC, assessing which procedures have been most used over the years.Methods: We evaluated a retrospective cohort of patients (2015-2020) with LC diagnosis. Demographic data, year of diagnose, histological type, clinical staging and diagnostic approach were registered. We performed a sequential analysis and inferential statistic considering two groups (2015-2017 and 2018-2020) to ascertain significant changes over the years.Results: A total of 303 patients were included, mean age was 70,8±11,2 years and 204 (67,3%) were male. The 2015-2017 group included 174 patients and the 2018-2020 group, 129. There are no significant differences in staging between two groups, although trends show a decline in squamous cell carcinoma (28,7% vs 18,6%, p 0,04) over the years. The most used procedure for both groups was flexible bronchoscopy (FB), follow by percutaneous transthoracic biopsy (PTB). We observed a significant chronological decrease in FB (59,7% vs 36,7%, p 0,01) and, in opposition, an increase of PTB (14,4% vs 25,6%, p 0,02) and endobronchial/esophageal ultrasound (EBUS/EUS-B) (3,4% vs 12,4%, p 0,01).Conclusions: Diagnostic modalities appear to be changing with decrease of FB and increase of PTB and EBUS/EUS-B. This may reflect a decrease of central lung tumors and the availability of more accuracy methods.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3853.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).