{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T08:59:37Z","timestamp":1785142777644,"version":"3.55.0"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can Assoc Radiol J"],"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To determine the prevalence of actionable incidental findings (AIFs) in a high-risk lung cancer screening cohort within a universal healthcare setting and identify potential opportunities in system-level quality improvement for AIF detection and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study identified all individuals that presented for a baseline lung cancer screening exam between August 2019 and September 2025. Structured computed tomography (CT) report text was extracted and included an affirmation of whether an AIF was present, a description of the AIF, and a management recommendation. AIF type and prevalence were compared to guideline literature to identify areas of lower-than-expected reporting. Comparisons were performed using\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests or chi-square tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 3169 unique individuals with eligible CT reports (37.2% female, 64.0\u2009\u00b1\u20095.2\u2009years of age) with 424 AIFs identified in 370 (11.7%) individuals. AIFs were associated with higher body mass index, active smoking, Lung-RADS score, and less common with a personal history of cancer (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05). Moderate or severe coronary artery calcification (n\u2009=\u2009106, 3.3%), thyroid lesions (n\u2009=\u200943, 1.4%), and interstitial lung abnormalities (n\u2009=\u200941, 1.3%) were most common. Bone mineral density (0%), vertebral fractures (0.1%), and indeterminate adrenal lesions (0.1%) were infrequently reported despite guidelines suggesting clinical relevance. Management recommendations were generally aligned with provincial program-specific guidance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>AIFs were common, but prevalence was relatively low for several key, potentially significant findings. Standardized reporting of AIFs and program-specific guidance is required considering the downstream costs associated with systematic identification of these AIFs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08465371261467271","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T07:51:26Z","timestamp":1784965886000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Actionable Incidental Findings at Baseline Lung Cancer Screening: Identifying Opportunities in a Universal Healthcare System"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7513-6118","authenticated-orcid":false,"given":"Adam","family":"Gaisinsky","sequence":"first","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9664-9999","authenticated-orcid":false,"given":"Lara Gabrielle","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic and Vascular Imaging, University Medical Imaging Toronto, University Health Network, ON, Canada"},{"name":"Division of Cardiothoracic Imaging, Department of Medical Imaging, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0178-1542","authenticated-orcid":false,"given":"Hussain","family":"Alshimali","sequence":"additional","affiliation":[{"name":"Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9433-6100","authenticated-orcid":false,"given":"Felipe","family":"Castillo","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic and Vascular Imaging, University Medical Imaging Toronto, University Health Network, ON, Canada"},{"name":"Division of Cardiothoracic Imaging, Department of Medical Imaging, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6520-6163","authenticated-orcid":false,"given":"Alina","family":"Blazer","sequence":"additional","affiliation":[{"name":"Division of Respirology, Department of Medicine, University Health Network, Toronto, ON, Canada"},{"name":"Division of Respirology, Department of Medicine, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5725-3258","authenticated-orcid":false,"given":"Micheal","family":"McInnis","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic and Vascular Imaging, University Medical Imaging Toronto, University Health Network, ON, Canada"},{"name":"Division of Cardiothoracic Imaging, Department of Medical Imaging, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Canadian Cancer Society. 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