2026 IASLC CT Screening and Early Detection Symposium-WS02.13 - Talk 3: Cardiovascular Disease in Screening CT

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Prof. Rozemarijn Vliegenthart’s presentation argues that lung cancer screening CT scans can also be used for cardiovascular disease (CVD) prevention. This is important because CVD is the leading global cause of death, and screenees are already at elevated risk due to age, sex, and smoking history. In major screening trials such as NLST and NELSON, CVD mortality was comparable to lung cancer mortality.<br /><br />The main opportunity is “one scan, two screenings”: modern chest CT images often visualize the heart well enough to detect coronary artery calcium (CAC), an early marker of atherosclerosis. CAC assessment on dedicated cardiac CT is standardized and strongly correlated with plaque burden, but evidence shows that chest CT can also detect CAC with good sensitivity and agreement, especially with newer scanners. Visual scoring on chest CT is fast, reproducible, and does not require extra software, and it performs similarly to Agatston scoring in predicting outcomes.<br /><br />Studies from large cohorts and screening trials show that CAC on chest CT is a strong predictor of future cardiovascular events and may add more predictive value than traditional risk factors alone. Importantly, reporting CAC can change management: it may prompt assessment of cardiovascular risk factors and increase statin use. This could improve the overall cost-effectiveness of lung cancer screening by preventing CVD events.<br /><br />The talk concludes that lung cancer screening CT offers a valuable chance to integrate CVD prevention. However, open questions remain about the best management strategy for different CAC levels, the optimal scan protocol, and whether CAC screening in this setting improves long-term outcomes.

Asset Subtitle

Rozemarijn Vliegenthart

Meta Tag

Concept Cardiovascular Disease

Concept Coronary Calcification

Concept Lung Cancer Screening CT

Concept Cardiovascular Event

Concept Cardiovascular Risk Assessment

Speaker Rozemarijn Vliegenthart

Keywords

lung cancer screening

cardiovascular disease prevention

coronary artery calcium

CT scans

atherosclerosis

Agatston scoring

visual scoring

statin therapy

NLST

NELSON

Cardiovascular Disease

Coronary Calcification

Lung Cancer Screening CT

Cardiovascular Event

Cardiovascular Risk Assessment

Rozemarijn Vliegenthart