Guidelines in context: Adapting the American Thoracic Society interstitial lung abnormalities clinical statement to Canadian practice

The 2025 American Thoracic Society (ATS) clinical statement on the approach to the evaluation and management of interstitial lung abnormalities (ILA) provides a structured, stepwise approach for clinicians. It defines interstitial lung disease (ILD), summarizes clinical, physiologic, genetic and radiologic factors associated with ILA progression, and outlines populations in whom “screening” chest CT may be appropriate. This clinical statement represents an important shift, reframing ILAs from an incidental radiologic finding to clinically meaningful entities with implications for patient care and health policy. In Canada, implementation of the ATS ILA clinical statement requires thoughtful contextualization within the healthcare system. The purpose of this “Guideline in Context” document is to synthesize the ATS recommendations and explore their application to Canadian practice, highlighting key opportunities, challenges and priorities for policy development and future research.