Using Coronary Artery Calcium Scoring as an Opportunity To Identify Lung Cancer Screening Eligible Patients

Lung cancer screening (LCS) with low-dose computed tomography (LDCT) has been shown to significantly reduce lung cancer-related mortality, yet screening rates remain lower than those for other cancer screening modalities. Coronary artery calcium scoring (CACS) exams may offer an opportunity to identify patients eligible for LCS, given the overlap in inclusion criteria for CACS and LDCT. We retrospectively analyzed patient data from all CACS exams conducted within our health system between January 1, 2022, and December 31, 2023. Of 14,923 CACS exams, approximately 15.8% to 23.4% (n = 2,354–3,488) of patients may be eligible for LCS, with 7.4% (n = 1,105) very likely eligible based on the 2022 United States Preventive Services Task Force (USPSTF) criteria. Notably, only 10.5% of these potentially eligible patients had undergone prior lung cancer screening at our institution. These findings suggest that CACS exams could serve as a valuable point of intervention to increase LCS uptake through systematic referral mechanisms.