Prevalence of incidental findings in computed tomographic screening of the chest: a systematic review.
OBJECTIVE
To perform a systematic review on the prevalence of incidental findings in computed tomographic (CT) screening studies of the chest.


METHODS
We selected CT screening studies of the chest (screening for coronary artery disease [CAD] [coronary calcium and CT coronary angiography] and lung cancer screening). Screening protocols, descriptions of baseline characteristics, range of incidental findings, and recommendations for follow-up were abstracted.


RESULTS
Eleven chest CT screening studies were identified. The proportion of people with at least 1 imaging abnormality requiring follow-up varied widely between studies (3%-41.5%). This was largely due to considerable variation in follow-up recommendations for incidental findings across studies. Analyzed by subgroup, 7.7% (confidence interval, 7.0%-8.3%) of 6421 participants in CAD screening had further investigations compared with 14.2% (confidence interval, 13.2%-15.2%) of 4531 participants in lung cancer screening.


CONCLUSIONS
In this review, 7.7% and 14.2% of patients undergoing either CAD or lung cancer screening with CT were found to have clinically significant incidental findings requiring additional investigations.
Jacobs
Peter C A
PC
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. p.c.a.jacobs@umcutrecht.nl
Mali
Willem P Th M
WP
Grobbee
Diederick E
DE
van der Graaf
Yolanda
Y
D002114:Calcinosis / Q000175:diagnosis / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D033162:Incidental Findings; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods*; D015995:Prevalence; D013902:Radiography, Thoracic / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*