Finding Heart Disease Through Lung Cancer Screening

With one low-dose computed tomography scan, people receive two screenings.

In addition to identifying suspicious masses, lung cancer screenings also can show atherosclerosis, or a buildup of fat and calcium, in the coronary arteries or the aorta.

“Atherosclerosis is often asymptomatic before causing a major cardiac event, so finding it incidentally during a scan gives us a chance to stop its progression,” says cardiologist Deborah Sundlof, DO, with Lehigh Valley Physician Group (LVPG) Cardiology.

At Lehigh Valley Health Network (LVHN), radiologists have developed a system for grading the severity of atherosclerosis found during lung cancer screening. Depending on the level of calcification, family medicine doctors and pulmonologists will recommend additional testing, certain treatment options or referral to LVHN’s cardiology program.

“Our grading system categorizes the level of calcification as none, mild, moderate or severe,” says radiologist Kenneth Cavorsi, MD, Chief, Section of Chest Radiology for LVHN. “Patients at the farther end of the scale are at a much higher risk for heart attack and stroke. By knowing this, their care team can provide individualized recommendations for their care.”

If patients are found to have both a lung nodule and atherosclerosis, their LVHN clinicians will work closely together to evaluate both conditions and recommend a treatment plan that is best for their overall health.

“A major push among our clinicians is collaboration,” says Sundlof, who also treats patients through LVHN’s cardio-oncology program. “Coming together from multiple disciplines allows us to address the full picture of our patients’ health and optimize their outcomes.”

“To be eligible for screening, patients need to have an extensive smoking history,” says pulmonologist C. Gerard Petersen, MD, with LVPG Pulmonary and Critical Care Medicine. “Along with being the biggest risk factor for lung cancer, smoking is one of the top risk factors for coronary artery disease. That’s why it isn’t surprising to find atherosclerosis in individuals who get screened.”

Individuals must meet all of the following criteria to receive a lung cancer screening:

• Be age 50-80
• Have a 20 pack-year smoking history (determined by multiplying the number of cigarette packs smoked per day by the number of years smoked)
• Currently smoke or have quit within the past 15 years