This multicenter, prospective study aims to evaluate the real-world clinical utility of chest X-ray (CXR) for large-scale thoracic disease screening. Adult participants presenting for health examinations will undergo digital CXR screening, and any suspected abnormalities will be confirmed via a gold standard reference, such as a chest CT scan or clinical follow-up. The primary outcome measure is the detection rate (screening yield) of confirmed thoracic conditions. Secondary measures will assess diagnostic accuracy (sensitivity and specificity), false-positive rates, and multi-center reading consistency. By providing prospective, large-cohort evidence, this research seeks to validate the cost-effectiveness and feasibility of CXR in identifying early-stage lung, pleural, and cardiac abnormalities, ultimately guiding public health strategies and optimizing early medical intervention.

Inclusion Criteria:

• Age over 18.
• Ability to understand and willingness to sign a written informed consent form.
• Individuals presenting for routine health examinations or community-based screening.

Exclusion Criteria:

• Women who are pregnant, lactating, or planning to become pregnant during the study period.
• Physical limitations preventing stable positioning or breath-holding, or presence of metallic implants that may significantly degrade image quality.
• Known history of advanced thoracic diseases currently under treatment (e.g., active lung cancer, end-stage pulmonary fibrosis, or congestive heart failure).
• Individuals who have undergone chest CT or X-ray examinations within the past 3 months.

Participants who received radiography for thoracic disease screen.