Evaluating the Incidence of Aortic Pathology Identified in Patients Undergoing Lung Cancer Screening CT Scans

Authors

• Mark Barlek, Corewell Health East Fellow
• Michael Robbe, Corewell Health East Resident
• Abigail Teitelbaum, Corewell Health East Resident
• Amira Rabbah, Oakland University William Beaumont School of Medicine Medical Student
• Baker Wilkes, Oakland University William Beaumont School of Medicine Medical Student
• Rose Callahan, Corewell Health East
• Diane Studzinski, Corewell Health East
• Graham Long, Corewell Health East
• Otto W. Brown, Corewell Health East

Document Type

Conference Proceeding

Publication Date

10-2026

Publication Title

Journal of Vascular Surgery

Abstract

Objective: Smoking is a known risk factor for developing aortic pathology. The Society for Vascular Surgery has screening guidelines for abdominal aortic aneurysms based on smoking history. There are no such guidelines for screening for thoracic aortic pathology. The primary objective of this study is to evaluate the prevalence of aortic pathology detected on lung cancer screening chest computed tomography (CT) scans. Methods: We conducted a retrospective review of patients who underwent one lung cancer screening CT at a single institution between January 2022 and December 2023. Radiology reports were reviewed to identify patients in whom the radiologist measured aortic size or provided a descriptive term to define a significant aortic finding. Measurements and descriptive terms were collected for the aortic root, ascending aorta, aortic arch, descending aorta, and abdominal aorta. Results: A total of 22,253 patients underwent a CT scan, with 1629 having a positive finding. Forty-two patients underwent prior aortic repair or were scheduled for a repair, leaving a study population of 1587. This resulted in a prevalence of aortic pathology of 7.1%. The most frequently involved aortic segment was the ascending aorta (1303), followed by aortic root (228), abdominal aorta (159), descending aorta (147), and aortic arch (109) (Table). A total of 1175 patients had an aortic segment measuring $4 cm; 12 penetrating ulcers and 2 dissections were also detected. A total of 274 patients had a positive aortic finding by description but did not contain an aortic measurement. Of those with aortic findings, the ascending aorta was most frequently involved for both males (83%) and females (78%). Females had more prevalent findings in the aortic arch (11%), descending aorta (13%), and abdominal aorta (14%) compared with men at 5%, 7%, and 8%, respectively. Conclusions: Aortic pathology was identified in 7.1% of patients undergoing screening chest CT for lung cancer. This appears to support routine screening for thoracic aortic pathology using in smokers.

Volume

84

Issue

4

First Page

e373

Last Page

e373

Recommended Citation

Barlek M, Robbe M, Teitelbaum A, Rabbah A, Wilkes B, Callahan R, et al. [Studzinski D, Long G, Brown OW]. Evaluating the incidence of aortic pathology identified in patients undergoing lung cancer screening CT scans. J Vas Surg. 2026 Oct;84(4):e373. doi:10.1016/j.jvs.2026.06.143

Comments

Eastern Vascular Society Annual Meeting, September 17-19, 2026, Washington, DC

DOI

10.1016/j.jvs.2026.06.143