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Coronary Calcium Scans Can Raise Cancer Risks

The U.S. Preventive Services Task Force recommends against using CT scans in screening programs, and the American Heart Association says they should be used for "selected individuals" at intermediate risk.

So what do physicians do about CAC scanning in the real world?

"I like using it for patients at intermediate risk of coronary disease, when I do not know how aggressive therapy should be," Einstein said. "For such patients, it is a fantastic test."

"In my practice I use it for patients with no symptoms but an unfavorable risk factor profile," Gerber said. "If there are risk factors but they are adamant about not changing their lifestyle or taking coronary medication, I think it sometimes helps patients realize their coronary atherosclerosis [hardening of the arteries] has begun."

A definitive study of the risk-benefit ratio of CAC scanning is unlikely, Einstein said. The people in question are not at high risk of heart disease, and "the rarer an event is, the larger the sample size that is needed," he said. "A randomized controlled trial would require hundreds of thousands or millions of patients, with adequate follow-up."

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Diane Porter

Cancer Guide