ArticlePloS one2023
Fully automated calcium scoring predicts all-cause mortality at 12 years in the MILD lung cancer screening trial.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 16 citations in OpenAlex.
- Exploring the prevalence and clinical impact of carotid plaque burden by Doppler ultrasound in lung cancer screening participants with limited coronary artery calcification.European radiology · 2026Article
- Early detection of cardiovascular disease in chest population screening: challenges for a rapidly emerging cardiac CT application.The British journal of radiology · 2025Review
- A Thorough Review of the Clinical Applications of Artificial Intelligence in Lung Cancer.Cancers · 2025Review
- Automated Measurement of Coronary Artery Calcifications and Routine Perioperative Blood Tests Predict Survival in Resected Stage I Lung Cancer.JTO clinical and research reports · 2025Article
- Lung Cancer Screening and Incidental Findings: A Research Agenda: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2025Review
- Can Artificial Intelligence Help Us in the Evaluation of Coronary Artery Calcification Scores by Acting as a Prognosticator in Patients That Are Operated on Due to Non-Small Cell Lung Cancer? A Pivotal Study.Journal of clinical medicine · 2024Article
- Artificial Intelligence in Coronary Artery Calcium Scoring.Journal of clinical medicine · 2024Review
- How will lung cancer screening and lung nodule management change the diagnostic and surgical lung cancer landscape?European respiratory review : an official journal of the European Respiratory Society · 2024Review
- Long-term outcomes of lung cancer screening in males and females.Lung cancer (Amsterdam, Netherlands) · 2023Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
Coronary artery calcium (CAC) is a known risk factor for cardiovascular (CV) events and mortality but is not yet routinely evaluated in low-dose computed tomography (LDCT)-based lung cancer screening (LCS). The present analysis explored the capacity of a fully automated CAC scoring to predict 12-year mortality in the Multicentric Italian Lung Detection (MILD) LCS trial. The study included 2239 volunteers of the MILD trial who underwent a baseline LDCT from September 2005 to January 2011, with a median follow-up of 190 months. The CAC score was measured by a commercially available fully automated artificial intelligence (AI) software and stratified into five strata: 0, 1-10, 11-100, 101-400, and > 400. Twelve-year all-cause mortality was 8.5% (191/2239) overall, 3.2% with CAC = 0, 4.9% with CAC = 1-10, 8.0% with CAC = 11-100, 11.5% with CAC = 101-400, and 17% with CAC > 400. In Cox proportional hazards regression analysis, CAC > 400 was associated with a higher 12-year all-cause mortality both in a univariate model (hazard ratio, HR, 5.75 [95% confidence interval, CI, 2.08-15.92] compared to CAC = 0) and after adjustment for baseline confounders (HR, 3.80 [95%CI, 1.35-10.74] compared to CAC = 0). All-cause mortality significantly increased with increasing CAC (7% in CAC ≤ 400 vs. 17% in CAC > 400, Log-Rank p-value <0.001). Non-cancer at 12 years mortality was 3% (67/2239) overall, 0.8% with CAC = 0, 1.0% with CAC = 1-10, 2.9% with CAC = 11-100, 3.6% with CAC = 101-400, and 8.2% with CAC > 400 (Grey's test p < 0.001). In Fine and Gray's competing risk model, CAC > 400 predicted 12-year non-cancer mortality in a univariate model (sub-distribution hazard ratio, SHR, 10.62 [95% confidence interval, CI, 1.43-78.98] compared to CAC = 0), but the association was no longer significant after adjustment for baseline confounders. In conclusion, fully automated CAC scoring was effective in predicting all-cause mortality at 12 years in a LCS setting.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.