Radiologists reporting CAC during lung cancer screening can strengthen preventative statin prescribing
Most patients undergoing lung cancer screening are eligible to receive statin drugs, yet these populations remain under prescribed. Radiologists have an opportunity to help close this gap by enhancing coronary artery calcium reporting during LCS exams.
That was the argument put forth by a multi-institutional group of North Carolina researchers in JACR. Patients with coronary artery calcium reported during their imaging exam were more than twice as likely to receive a downstream statin prescription compared to those without.
There are many reasons for this, the authors noted, but providers’ lack of knowledge regarding atherosclerotic cardiovascular disease risk in this specific population is a likely contributor.
Reporting CAC alone won’t be enough to address the statin gap, but it can help raise awareness for ASCVD as the top killer of individuals undergoing lung cancer screening, Tina D. Tailor, MD, director of Cardiothoracic Radiology Research at Duke University Medical, and colleagues explained.
“Given the potential for approximately 8 million LCS examinations each year, there is a significant need for accurate ASCVD risk assessment and implementation of risk reduction strategies in this population,” the authors added Feb. 26. “Within the context of increasing LCS utilization...and the growing interest in patient-centered radiology reporting to educate patients about imaging results, communication of LCS-detected CAC to patients could serve as a potential motivator for statin initiation or adherence,” they added later.
For their study, the researchers retrospectively analyzed 5,495 participants who received LCS across three centers between January 2016 and December 2018. Of that total, 31.4% had preexisting ASCVD, with 73.6% of the remaining 3,771 patients eligible for statins. Despite this, 60.5% did not have a prescription for such medication.
Breaking it down further, those with CAC reported during screening exams were twice as likely to receive a downstream prescription, with that likelihood increasing as artery calcium worsened.
A number of interventions will be necessary to help doctors better identify ASCVD risk in these patients, but for radiologists, consensus regarding CAC documentation should be near the top, the authors wrote. Future updates to the ACR Lung Reporting and Data systems should incorporate standardized reporting, they added.
“In summary, although the majority of individuals receiving LCS are eligible for preventive statin therapy, statins are under prescribed in this population,” Tailor and colleagues concluded. “Bridging the statin gap in this population will require a multifaceted strategy, and the reporting of LCS-detected CAC presence and severity by radiologists may be one opportunity to improve statin prescribing.”
Read more about the study published in the Journal of the American College of Radiology here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.