Coronary Artery Calcification Identified on Lung Cancer Screening CT Scans: A Scoping Review.

Abstract

TOPIC IMPORTANCE Coronary artery calcification (CAC) can be a significant incidental finding on low-dose computed tomography (CT) scans performed for lung cancer screening (LCS). CAC presence and grade hold important diagnostic, and preventive value, particularly in patients without previously recognized coronary artery disease. This scoping review describes the prevalence of CAC as an incidental finding on LCS CT scans across prior studies and identifies directions for future research. REVIEW FINDINGS The initial search resulted in 256 abstracts screened for eligibility, resulting in 32 articles included in the final review. CAC presence across included studies varied from 14.8% to 98%. CAC was most commonly reported as mild in grade, among 46.9% of studies. The majority of studies were conducted among predominantly White male participants. Finally, only 6 articles provided information on down-stream interventions for patients with newly detected CAC. SUMMARY CAC, a predictive risk factor for cardiovascular events and mortality, is a frequently detected incidental finding on LCS CT scans, with substantial variation in presence across studies. Identification of CAC on LCS CT could inform clinical decisions to reduce patients' overall cardiovascular risk. These findings underscore the significance of standardizing the documentation and management of CAC in LCS. Finally, future studies should include greater race diversity.