RESUMO Os programas de rastreamento de câncer de pulmão (RCP) estão aumentando em todo o mundo. Achados incidentais (AI) no RCP são achados de TC de baixa dose sem relação com o propósito principal de identificar câncer de pulmão. A maioria dos AI no RCP é benigna e clinicamente insignificante, mas os AI estão sendo cada vez mais reconhecidos, e alguns requerem encaminhamento urgente para investigação diagnóstica adicional. Outros achados são esperados e conhecidos como comorbidades relacionadas ao tabagismo, tais como DPOC, doença cardiovascular, enfisema e doença pulmonar intersticial, e seu diagnóstico pode ter um impacto significativo no prognóstico do paciente. O propósito deste ensaio pictórico é ilustrar os AI mais comuns no RCP, organizados por órgão/sistema. Discutiremos a literatura atual a respeito de AI no RCP, com foco em sua prevalência, comunicação apropriada e desencadeamento de procedimentos clínicos.

ABSTRACT Lung cancer screening (LCS) programs are increasing worldwide. Incidental findings (IFs) on LCS are defined as low-dose CT findings unrelated to the primary purpose of identifying lung cancer. Most IFs on LCS are benign and clinically insignificant but are being increasingly recognized, and some require urgent referral for further diagnostic workup. Other findings are expected and are known as smoking-related comorbidities, including COPD, cardiovascular disease, emphysema, and interstitial lung disease, and their diagnosis can have a significant impact on patient prognosis. The purpose of this pictorial essay is to illustrate the most common IFs on LCS, organized by organ. We will discuss the current literature on IFs on LCS, focusing on their prevalence, appropriate communication, and triggering of clinical pathway systems.

Objectives: To assess the prevalence of children's exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. Methods: In 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N = 3187, mean age 9.5 ± 0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. Results: Of the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Children's exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p<.001). Therefore, children with smoking parents were 5.44 times more likely to be exposed. Conclusions: Children's exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard.

Objetivos: Describir la prevalencia de la exposición de niños y niñas al humo ambiental del tabaco en el coche familiar; comparar la exposición de niños y niñas con padres fumadores y no fumadores. Métodos: En 2011, se aplicó un cuestionario auto-administrado a una muestra de niños y niñas portugueses de 4º curso (N = 3187, edad promedio 9,5 ± 0,7, 51,1% varones). Se calcularon ratios de prevalencia y pruebas de chi-cuadrado. Resultados: El 52,0% informaron tener al menos un padre/madre fumador. En la muestra total, la exposición fue del 28,9% (CI95%: 27,3-30,5). Esta exposición fue del 46,9% (CI95%:44,4-49,4) entre los niños y niñas con padres fumadores y del 8,6% (CI95%:7,1-10,1) entre los con padres no fumadores (p < 0,001), por lo tanto, fue más de cinco veces mayor entre los niños y niñas con padres fumadores. Conclusiones: La exposición es alta, especialmente si uno o ambos padres fuman. Esto indica la necesidad de medidas de control efectivo del consumo de tabaco para prevenir este severo riesgo para la salud.

Objectives: To assess the prevalence of children's exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. Methods: In 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N = 3187, mean age 9.5 ± 0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. Results: Of the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Children's exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p<.001). Therefore, children with smoking parents were 5.44 times more likely to be exposed. Conclusions: Children's exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard.

Objetivos: Describir la prevalencia de la exposición de niños y niñas al humo ambiental del tabaco en el coche familiar; comparar la exposición de niños y niñas con padres fumadores y no fumadores. Métodos: En 2011, se aplicó un cuestionario auto-administrado a una muestra de niños y niñas portugueses de 4º curso (N = 3187, edad promedio 9,5 ± 0,7, 51,1% varones). Se calcularon ratios de prevalencia y pruebas de chi-cuadrado. Resultados: El 52,0% informaron tener al menos un padre/madre fumador. En la muestra total, la exposición fue del 28,9% (CI95%: 27,3-30,5). Esta exposición fue del 46,9% (CI95%:44,4-49,4) entre los niños y niñas con padres fumadores y del 8,6% (CI95%:7,1-10,1) entre los con padres no fumadores (p < 0,001), por lo tanto, fue más de cinco veces mayor entre los niños y niñas con padres fumadores. Conclusiones: La exposición es alta, especialmente si uno o ambos padres fuman. Esto indica la necesidad de medidas de control efectivo del consumo de tabaco para prevenir este severo riesgo para la salud.