Risks and Costs of Routine Preventive Coronary Artery Calcium Scans

Schade, Arora, and Eaton make an interesting comparison between routine preventive colonoscopy and coronary artery calcium scanning.1 However, an important distinction between these modalities is that radiological tests invariably lead to incidental findings, which have been a long-standing concern with cardiac imaging.2,3 Investigations of various cardiac imaging modalities have repeatedly shown high rates of incidental findings, few of which are clinically significant, and high costs associated with the cascade workups.