DECAMP-1: Diagnosis and Surveillance of Indeterminate Pulmonary Nodules

Inclusion Criteria: * 45 years of age or older; * Initial diagnosis of indeterminate pulmonary nodule (0.7-3.0 cm); * Smoking status: Current or former smoker with ≥ 20 pack years (pack years = number of packs per day X number of years smoked) * Willing to undergo fiberoptic bronchoscopy; * Able to tolerate all biospecimen collection as required by protocol; * Able to comply with standard of care follow up visits including clinical exams, diagnostic work-ups, and imaging for a minimum of two years; * Able to fill out Patient Lung History questionnaire; * Willing and able to provide a written informed consent. Exclusion Criteria: * History or previous diagnosis of lung cancer; * Diagnosis of pure ground glass opacities on chest CT; * Contraindications to nasal brushing or fiberoptic bronchoscopy including ulcerative nasal disease, hemodynamic instability, severe obstructive airway disease, unstable cardiac or pulmonary disease; inability to protect airway or altered level of consciousness; * Allergies to any local anesthetic that may be used to obtain biosamples in the study.