Lung cancer screening with low-dose chest computed tomography (CT) may be capable of identifying coronary artery calcium in patients without cardiac symptoms, according to a recent study published by Caires et al in the Canadian Medical Association Journal.
Background
Lung cancer is currently one of the leading causes of cancer-related mortality. Screening programs have introduced low-dose CT for patients at risk of lung cancer. These CTs can also easily identify coronary calcification, a marker of coronary artery disease—which is the most common cause of cardiac death.
“Lung cancer screening, although primarily geared toward reducing deaths from lung cancer, also has an opportunity to help tackle the second most common cause of premature death in middle-aged adults through the identification and risk stratification of coronary atherosclerosis,” emphasized senior study author Gary Small, MBChB, PhD, of the University of Ottawa Heart Institute.
Study Methods and Results
In the recent study, researchers screened 1,486 patients for lung cancer between March 2017 and November 2018 as part of the Ontario Health Lung Cancer Screening Pilot for People at High Risk. They noted that 52% of the patients were male, the mean patient age was 66 years, and 68% (n = 1,017) were current smokers.
The researchers detected coronary artery calcium in 83% (n = 1,232) of the patients, with high levels in 30% (n = 439) of them.
Conclusions
“If appropriate therapeutic responses are instituted, lung CT findings could affect survival from two leading causes of death: lung cancer and coronary artery disease,” highlighted the study authors.
The success of the pilot program will be affected by how physicians interpret and manage findings of coronary artery calcium. However, physicians should be aware of the risk of CTs, such as inappropriate investigation after coincidental detection.
The researchers suggested that more research may be needed to identify strategies to manage patients with coincidentally detected coronary artery calcium.
“[C]ontinued attention to cardiovascular disease prevention is warranted and could be amalgamated into lung cancer screening initiatives to promote health,” the study authors concluded.
Disclosure: For full disclosures of the study authors, visit cmaj.ca.
