肺间质异常（ILA）是低剂量CT肺癌筛查参与者中相对常见的偶然发现。一些ILA是短暂和无关紧要的，但其他的则代表着间质性肺病（ILD）。因此，肺癌筛查为一些筛查参与者提供了早期诊断和治疗ILD的机会。本研究报道了约克郡肺部筛查试验基线筛查阶段参与者的ILA患病率，以及被转介到区域ILD服务的比例、最终的诊断、结果和治疗情况。在进行筛查的6650名参与者中，169名（2.5%）患者报告了ILA。经过筛查审查会议的评估后，将56名参与者转介到ILD服务进行进一步评估（占所有筛查参与者的0.8%）。2名参与者拒绝接受转诊，1名目前正在等待评估，剩下的53名被确认为ILD患者。最终的诊断结果包括特发性肺纤维化（n=14）、呼吸道细支气管间质性肺病（n=4）、慢性过敏性肺炎（n=2）、结缔组织病/类风湿性关节炎相关ILD（n=4）、石棉肺病（n=1）、特发性非特异性间质性肺炎（n=1）、结节病（n=1）和胸膜间质纤维弹性过增（n=1）。有25名患者患有无法分类的特发性间质性肺炎。总体而言，10人接受了药物治疗（7人使用抗纤维化药物，3人使用泼尼松），占ILD服务转诊人数的18%，占进行筛查的人数的0.15%。有32人在ILD服务中接受监测，其中一些可能在未来需要治疗。肺癌筛查可以发现临床意义重大的ILD病例，使部分参与者能够早期开始疾病修复性治疗。这是迄今为止最大的筛查队列，报告了最终的诊断和治疗结果，并提供了在实施肺癌筛查时ILD服务可预期的临床活动水平的估计。需要进一步研究以阐明筛查发现的ILD的最佳管理方法。ISRCTN42704678。© 作者（或其雇主）2023年发表。根据CC BY许可进行再使用。由BMJ出版。

Interstitial lung abnormalities (ILA) are relatively common incidental findings in participants undergoing low-dose CT screening for lung cancer. Some ILA are transient and inconsequential, but others represent interstitial lung disease (ILD). Lung cancer screening therefore offers the opportunity of earlier diagnosis and treatment of ILD for some screening participants.The prevalence of ILA in participants in the baseline screening round of the Yorkshire Lung Screening Trial is reported, along with the proportion referred to a regional ILD service, eventual diagnoses, outcomes and treatments.Of 6650 participants undergoing screening, ILA were reported in 169 (2.5%) participants. Following review in a screening review meeting, 56 participants were referred to the ILD service for further evaluation (0.8% of all screening participants). 2 participants declined referral, 1 is currently awaiting review and the remaining 53 were confirmed as having ILD. Eventual diagnoses were idiopathic pulmonary fibrosis (n=14), respiratory bronchiolitis ILD (n=4), chronic hypersensitivity pneumonitis (n=2), connective tissue disease/rheumatoid arthritis-related ILD (n=4), asbestosis (n=1), idiopathic non-specific interstitial pneumonia (n=1), sarcoidosis (n=1) and pleuroparenchymal fibroelastosis (n=1). Twenty five patients had unclassifiable idiopathic interstitial pneumonia. Overall, 10 people received pharmacotherapy (7 antifibrotics and 3 prednisolone) representing 18% of those referred to the ILD service and 0.15% of those undergoing screening. 32 people remain under surveillance in the ILD service, some of whom may require treatment in future.Lung cancer screening detects clinically significant cases of ILD allowing early commencement of disease-modifying treatment in a proportion of participants. This is the largest screening cohort to report eventual diagnoses and treatments and provides an estimate of the level of clinical activity to be expected by ILD services as lung cancer screening is implemented. Further research is needed to clarify the optimal management of screen-detected ILD.ISRCTN42704678.© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.