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Clinical Relevance and Management of "Pre-Interstitial Lung Disease". Cellular level changes that lead to interstitial lung disease (ILD) may take years to become clinically apparent and have been termed preclinical ILD. Incidentally identified interstitial lung abnormalities (ILA) are increasingly being recognized on chest computed tomographic scans done as part of lung cancer screening and for other purposes. Many individuals found to have ILA will progress to clinically significant ILD. ILA are independently associated with greater risk of death, lung function decline, and incident lung cancer. Current management recommendations focus on identifying individuals with ILA at high risk of progression, through a combination of clinical and radiological features.