American Board of Internal Medicine (ABIM) Certification Practice Exam

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What is the first step in the workup for non-small cell lung cancer (NSCLC)?

CT scan
Biopsy
Blood tests
Imaging studies

The correct answer is: Biopsy

The first step in the workup for non-small cell lung cancer (NSCLC) is a biopsy. A definitive diagnosis of lung cancer necessitates obtaining tissue samples to confirm the presence of malignant cells. Biopsy methods can include bronchoscopy, CT-guided needle biopsy, or thoracotomy, depending on the tumor's location and accessibility. While imaging studies, such as CT scans and PET scans, are vital for assessing the stage of cancer and identifying potential spread, they cannot provide a definitive diagnosis alone. Blood tests may be utilized to assess overall health or tumor markers, but they are not specific for diagnosing lung cancer. Therefore, obtaining a biopsy is essential to establish a diagnosis and determine the appropriate treatment plan for NSCLC.