Conflict of interest: K.M. Fong reports grants from MRFF EPCDR (Improving Diagnosis in Cancers Low Survival Rates), NHMRC (Ideas grant: Early lung cancer biomarkers), MRFF Next Generation Clinical Researchers Program (Practitioner Fellowship), NHMRC Project (Novel biomarkers for lung cancer), NHMRC (low dose computed tomography to diagnose lung cancer); royalties from UpToDate and Cochrane Clinical Answers; unpaid leadership role at Asia Pacific Society of Respirology (former President); support with a loan bronchoscope for 12 months for the purpose of a research trial study (no financial funding) from Olympus; software licensing for computer aided diagnosis research in the International Lung Screen Trial (ILST) from Mevis Veolity; outside the submitted work. G.N. Olive and R.V. Bowman report receipt of loan bronchoscopes from Olympus Australia; outside the submitted work. H. Marshall reports grants from NHMRC and MRFF; lecture honoraria from AstraZeneca and Boehringer Ingelheim; travel and accommodation expenses from Boehringer Ingelheim; special interest group convenor (tobacco control) for Thoracic Society ANZ (unpaid); expert advisory member (lung cancer advocacy) for Lung Foundation Australia (unpaid); education committee member for Asian Pacific Society of Respirology (unpaid); outside the submitted work. I.A. Yang has nothing to disclose.