[Early diagnosis in interstitial lung diseases and its impact]

Delayed diagnosis of interstitial lung diseases (ILD), particularly fibrosing forms, poses a significant major clinical and healthcare challenge. The nonspecific nature of early symptoms, underdetection of characteristic physical signs such as "velcro" crackles, and the nonspecialized interpretation of high-resolution computed tomography contribute to diagnostic delays, further exacerbated by healthcare system fragmentation and limited access to specialized centers. Current evidence suggests that this delay, which can exceed two years from symptom onset, is associated with greater functional impairment, reduced survival, increased acute exacerbations, more frequent hospitalizations, and higher healthcare costs. Each additional year of delay correlates with greater fibrosis progression and higher mortality risk. Conversely, patients evaluated in specialized centers with multidisciplinary teams demonstrate better clinical outcomes, lower mortality, and improved quality of life, partially mediated by increased access to antifibrotic therapy. Expert imaging interpretation and joint assessment by pulmonologists, radiologists, and rheumatologists enhance diagnostic accuracy and optimize therapeutic decisions. Overall, early diagnosis in fibrosing ILD should be regarded as a therapeutic intervention in itself, capable of modifying the natural history of the disease, improving quality of life, and reducing both the economic and emotional burden for patients and healthcare systems.