Prevalence of incidental findings in computed tomographic screening of the chest: a systematic review

J Comput Assist Tomogr. 2008 Mar-Apr;32(2):214-21. doi: 10.1097/RCT.0b013e3181585ff2.


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.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Calcinosis / diagnosis
  • Calcinosis / epidemiology
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / epidemiology
  • Humans
  • Incidental Findings*
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / epidemiology
  • Mass Screening / methods*
  • Prevalence
  • Radiography, Thoracic / methods*
  • Tomography, X-Ray Computed / methods*