ERS3033. Lung Cancer Screening: Impact of Age Screenees Began Smoking or Had Secondhand Smoke Exposure on Coronary Artery Calcium Scores
Authors * Denotes Presenting Author
  1. Tyler Cook *; VCU School of Medicine
  2. Sarah Warner; VCU School of Medicine
  3. Mark Parker; VCU School of Medicine
  4. Leila Rezai Gharai; VCU Health
  5. Asem Rahman; VCU Health
Low Dose CT (LDCT) lung cancer screening may detect unsuspected coronary artery calcifications (CAC). Our team developed a qualitative CAC scoring system for our lung cancer screening program. The purpose of this study is to determine a relationship between our CAC scoring system, left main (LM) involvement, age at which screenees began smoking and secondhand smoke exposure.

Materials and Methods:
Following Institutional Review Board approval, we conducted a retrospective review of LDCTs from our lung screening program between January 2013 and June 2021. Age, sex, smoking status, pack-years, CAC, and LM-score were acquired from electronic medical records. Our radiologists used a qualitative CAC-scoring system on LDCT studies. Score: 0: no calcifications. Score 1: <1/3 vessel length affected. Score 2: >1/3 but <2/3 vessel length affected. Score 3: >2/3 vessel length affected. Total possible score for 4 vessels: 12/12. Results were collected and analyzed from 984 participants producing a total of 1,857 observations, with a portion of screenees having multiple visits.

We found significant differences between total-CAC score and pack-years (F12,1120 = 4.16, p<0.0001). Post-hoc tests show relationships between higher CAC-scores and pack-years. We found significant differences (F3,1181 = 4.96, p = 0.0020) between LM- CAC scores and pack-years. In both cases, higher CAC-scores correlated with more cumulative pack-years. Chi-square analysis revealed no significant relationships between CAC-score and second-hand smoke exposure, CAC-score and age screenees began smoking, CAC and parental smoke exposure, LM-CAC score and second-hand smoke exposure, LM-CAC score and age screenees began smoking, LM-CAC score and parental smoke exposure.

Our study shows relationships between increasing pack-years, CAC-score, and LM-CAC scores but no relationship between CAC, LM-CAC scores, and age at which screenees began smoking or secondhand smoke exposure. LDCT can qualitatively assess CACs. Given the increased morbidity associated with CACs our system could be used in the LungRADS reporting system as an “S” finding.