It is known that both CT and VOC breath test can detect stage 1 cancer of the lung which has at least a 50% cure rate. There is potential however that VOC can detect even earlier stages of lung cancer, such as in-situ-carcinoma which when properly staged and treated has over 95% long term cure rate. It is possible that VOC testing will ultimately be used in larynx cancer screening either as the first step (high negative predictive value) or as a second line test to further evaluate equivocal results of screening low dose CT chest. Also, we have expertise in NBI and fluorescence bronchoscopy and our focus is on the management of the type of early lesions found by this approach.