National VA Survey: PCPs and Radiologists Prefer Lung Screening Incidental Findings in the Radiology Report

VA survey: 95% of primary care clinicians and radiologists preferred lung screening incidental findings be reported in the radiology report, not direct contact. Most primary care clinicians also wanted them on baseline and follow-up exams, despite ACR guidance to report only new…

• Cross-sectional electronic survey of 560 primary care clinicians and 55 radiologists in the Veterans Health Administration (August-September 2025) used vignettes for coronary artery calcification, emphysema, and pulmonary fibrosis.
• 95% of respondents preferred incidental findings in the radiology report over direct communication; primary care clinicians wanted findings in both Impression and Findings sections and on baseline/follow-up exams (68% coronary artery calcification, 68% emphysema, 75% pulmonary fibrosis).
• Most radiologists said they report these incidental findings, but some do not use the S-modifier; AI review of prior diagnoses was favored by 76% of primary care clinicians and 82% of radiologists.

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