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Lung cancer (LC) is the most prevalent cancer worldwide, and responsible for over 1.3 million deaths each year. Currently, LC has a low five year survival rates relative to other cancers, and thus, novel methods to screen for and diagnose malignancies are necessary to improve patient outcomes. Here, we report on a pilot-sized study to evaluate the potential of the sputum microbiome as a source of non-invasive bacterial biomarkers for lung cancer status and stage. Spontaneous sputum samples were collected from ten patients referred with possible LC, of which four were eventually diagnosed with LC (LC + ), and six had no LC after one year (LC - ). Of the seven bacterial species found in all samples,  Streptococcus viridans  was significantly higher in LC +  samples. Seven further bacterial species were found only in LC - , and 16 were found only in samples from LC + . Additional taxonomic differences were identified in regards to significant fold changes between LC +  and LC - cases, with five species having significantly higher abundances in LC + , with  Granulicatella adiacens  showing the highest level of abundance change. Functional differences, evident through significant fold changes, included polyamine metabolism and iron siderophore receptors.  G .  adiacens  abundance was correlated with six other bacterial species, namely  Enterococcus  sp. 130,  Streptococcus intermedius ,  Escherichia coli ,  S .  viridans ,  Acinetobacter junii , and  Streptococcus  sp. 6, in LC +  samples only, which could also be related to LC stage. Spontaneous sputum appears to be a viable source of bacterial biomarkers which may have utility as biomarkers for LC status and stage.

A pilot study using metagenomic sequencing of the sputum microbiome suggests potential bacterial biomarkers for lung cancer