Incidental Detection of Coronary Artery Calcification in Women Undergoing Cancer Screening or Treatment

Cardiovascular disease and cancer are significant causes of morbidity and mortality. Cancer screening in woman provides an opportunity to detect early signs of cardiovascular disease. Women who undergo cancer screening or treatment may have imaging that directly visualizes the coronary arteries, presenting an opportunity to detect cardiovascular disease. This is particularly important in women without traditional cardiovascular risk factors who may be as low risk. This review aims to assess current evidence of the incidental detection of coronary artery calcification (CAC) in women undergoing cancer screening or treatment.

Current evidence demonstrates that CAC is prevalent but underreported in this population. Elevated CAC scores are associated with increased cardiovascular mortality. There is also poor follow-up and post-detection management in cancer patients with evidence of CAC. Overall, the incidental detection of CAC allows for personalized risk stratification and reclassification. However, despite frequent detection, CAC is underreported and rarely translated into guideline-directed preventative care including lipid lowering therapies, antiplatelet agents, and additional workup, representing a critical gap, particularly in women.