AI Insight
A retrospective study of 3,100 statin-eligible adults undergoing lung cancer screening in Missouri found that only 27.3% received statin prescriptions within one year, despite being at high risk for cardiovascular disease. Earlier statin initiation was associated with higher calculated cardiovascular risk, recent cardiology visits, and former versus current smoking status, but not with race, insurance type, or socioeconomic factors. Most high-risk patients remained untreated, suggesting systematic gaps in preventive cardiovascular care during lung cancer screening encounters.
Why it matters
Lung cancer screening presents a missed opportunity to address cardiovascular disease in high-risk populations, as most eligible patients leave without appropriate preventive therapy. Integrating cardiovascular risk assessment and treatment protocols into screening workflows could help prevent heart attacks and strokes in this vulnerable population.
Understand the Science
⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Background: Individuals undergoing lung cancer screening (LCS) represent a population at high risk for atherosclerotic cardiovascular disease (ASCVD), yet opportunities for cardiovascular prevention during screening encounters may be underutilized. While prior studies have examined whether statins are prescribed in eligible patients, little is known about the timing of statin initiation following LCS, particularly among statin-naive individuals. Methods: We conducted a retrospective cohort study using electronic health record data from a large academic health system in Missouri. Adults aged 50-80 who underwent LCS between January 1, 2015, and December 31, 2023, were statin-naive, and met 2019 ACC/AHA criteria for primary prevention were included. The primary outcome was time-to-statin initiation following LCS. Kaplan-Meier methods and Cox proportional hazards models were used to evaluate timing and predictors of statin initiation across demographic, clinical, and socioeconomic subgroups. Results: Among 3,100 statin-eligible, statin-naive individuals who had undergone LCS, only 27.3% were prescribed a statin within one year of LCS. Uptake accrued gradually (10.5% by 90 days; 17.8% by 180 days; 23.2% by 270 days; 27.1% by 360 days). In adjusted models, earlier statin initiation was independently associated with a higher ASCVD risk category, a cardiology visit in the year preceding LCS, and former (versus current) smoking; older age and male sex were associated with slower initiation. Race, insurance type, and area deprivation were not independently associated with time-to-statin initiation. Conclusions: Despite high ASCVD risk, most statin-eligible patients undergoing LCS did not receive timely statin therapy. Earlier initiation tracked calculated ASCVD risk and specialty (cardiology) contact rather than race, sex, insurance, or area deprivation. Because most patients at high calculated risk still went untreated, integrating cardiovascular risk assessment and preventive decision support into LCS workflows may help reduce missed opportunities for ASCVD prevention.