In the NLST, 1.2% of patients who were not found to have lung cancer underwent an invasive procedure such as needle biopsy or bronchoscopy, while 0.7% of patients who were not found to have lung cancer had a thoracoscopy, mediastinoscopy, or thoracotomy.23 In the NELSON study, these numbers were 1.2% and 0.6%, respectively.18 Invasive nonsurgical procedures in patients with benign lesions were com