{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:46:59Z","timestamp":1775018819876,"version":"3.50.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT","doi-asserted-by":"publisher","award":["RS-2023-00207978"],"award-info":[{"award-number":["RS-2023-00207978"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Interstitial lung abnormalities (ILAs) and emphysema are frequently detected during lung cancer screening (LCS), but the impact of their coexistence\u2014termed combined ILA and emphysema (CILAE)\u2014on lung cancer risk remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the prevalence of CILAE in a national LCS cohort, evaluate whether its effect on lung cancer risk is additive or multiplicative, and quantify its association with lung cancer incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study analyzed data from the Korean national LCS program (2019-2020). Participants were categorized into 4 CT-defined groups: neither condition, emphysema alone, ILA alone, and CILAE. Lung cancer incidence rate ratios (IRRs) were calculated using the neither condition group as the reference. Cox proportional hazards regression, adjusted for demographic and clinical factors, assessed the interaction and risk associated with CILAE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 125\u200a600 participants, CILAE was present in 1.0% (1223\/125\u200a600), ILA alone in 1.7% (2101\/125\u200a600), and emphysema alone in 12.8% (16\u200a077\/125\u200a600). Over a median follow-up of 2.8\u2009years (95% confidence interval [CI], 2.8-2.9\u2009years), lung cancer was diagnosed in 1.4% (1709\/125\u200a600). Compared to neither condition, IRRs for lung cancer were 9.12 (95% CI, 7.39-11.0) for CILAE, 4.51 (95% CI, 3.63-5.44) for ILA alone, and 2.93 (95% CI, 2.66-3.20) for emphysema alone. Adjusted hazard ratios [HRs] for lung cancer were 5.17 (95% CI, 4.21-6.35; P\u2009&amp;lt;\u2009.001) for CILAE, 3.10 (95% CI, 2.50-3.84; P\u2009&amp;lt;\u2009.001) for ILA alone, and 2.05 (95% CI, 1.83-2.30; P\u2009&amp;lt;\u2009.001) for emphysema alone. The interaction term between ILA and emphysema was not significant (adjusted HR, 0.81 [95% CI, 0.60-1.10]; P\u2009=\u2009.17), suggesting an additive rather than multiplicative effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CILAE was present in 1% of LCS participants and was associated with a lung cancer risk exceeding that of ILA or emphysema alone. The combined effect was additive rather than synergistic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annalsats\/aaoaf068","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:02:18Z","timestamp":1769158938000},"page":"621-628","source":"Crossref","is-referenced-by-count":2,"title":["Additive lung cancer risk in combined interstitial lung abnormalities and emphysema: Korean national lung cancer screening program"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0722-0033","authenticated-orcid":false,"given":"Hyungjin","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Radiology, Seoul National University Hospital and College of Medicine , Seoul,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong Hyuk","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul National University Hospital and College of 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BC,","place":["Canada"]},{"name":"Center for Heart Lung Innovation, St Paul\u2019s Hospital , Vancouver, BC,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter M","family":"George","sequence":"additional","affiliation":[{"name":"Department of Interstitial Lung Disease, Royal Brompton Hospital , London,","place":["United Kingdom"]},{"name":"National Heart and Lung Institute, Imperial College London , London,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeun-Chung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiology, College of Medicine, National Taiwan University , Taipei,","place":["Taiwan"]},{"name":"Department of Medical Imaging, National Taiwan University Hospital , Taipei,","place":["Taiwan"]},{"name":"Department of Medical Imaging, National Taiwan University Cancer Center , , Taipei","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Mo","family":"Goo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul National University Hospital and College of Medicine , Seoul,","place":["Korea"]},{"name":"Institute of Radiation Medicine, Seoul National University Medical Research Center , , Seoul","place":["Korea"]},{"name":"Seoul National University Cancer Research Institute, Seoul National University College of Medicine , Seoul,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"2026033111265035600_aaoaf068-B1","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1056\/NEJMoa1102873","article-title":"Reduced lung-cancer mortality with low-dose computed tomographic screening","volume":"365","author":"Aberle","year":"2011","journal-title":"N Engl J 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