Lung Cancer Biomarkers: A New Frontier in Early Detection with Lindsey Cotton, DO, DHSc, MS

Lung cancer remains the leading cause of cancer-related death in the United States, responsible for more than 127,000 deaths annually. Despite advancements in treatment, survival outcomes remain closely tied to the stage at diagnosis—making early detection a critical focus in public health. While current U.S. Preventive Services Task Force (USPSTF) recommendations endorse screening for only a handful of cancers—lung, breast, cervical, and colorectal—these organ-specific guidelines leave the majority of lethal cancers without structured early detection strategies.

Recent innovations in biomarker development have aimed to address this gap, using noninvasive methods such as blood, urine, saliva, or stool to detect cancer at early stages. Two major categories of these tools are emerging: organ-specific early detection tests and multi-cancer early detection tests (MCEDs), the latter offering the potential to identify multiple malignancies from a single blood sample. For lung cancer, both types of biomarkers are under active investigation, with ongoing efforts focused on improving accuracy, defining appropriate use populations, and addressing challenges related to cost, downstream testing, and insurance coverage.

Joining our host Albert Rizzo, MD, in this episode of Lungcast is clinician-scientist and expert in liquid biopsy development Lindsey Cotton, DO, DHSc, MS, chief medical officer of Cotton Medical Consultants. Cotton explores the evolving science of lung cancer biomarkers and their role in early detection and details the benefits and challenges of both organ-specific and multi-cancer tests.

“We need to move beyond this one size fits all screening recommendations. We need to take a more personalized approach looking at comprehensive risk assessment. I've been really fortunate to have a swarm of academic colleagues and peers as thought partners that are making so many incredible, groundbreaking movements in this area,” Cotton said. “I would also say it doesn't matter how great a test is. I want to emphasize the importance of implementation science in this field. Even the best test won't save lives if it isn't used, we don't have access, or it's not covered.”

Lungcast is a monthly respiratory news podcast series hosted by Albert Rizzo, MD, chief medical officer of the ALA, and produced by HCPLive.

Subscribe to Lungcast on Spotify here, or listen to the episode below.