Smoking-Related Comorbidities Detected Through Low-Dose CT Imaging Lung Cancer Screening: Current Evidence and Future Directions

Low-dose CT (LDCT) imaging has been established in the past decade as an important and effective tool for lung cancer screening (LCS) in high-risk individuals, with large trials demonstrating significant lung cancer mortality reduction. Beyond pulmonary nodules, LDCT imaging frequently detects a range of smoking-related additional findings, including emphysema, coronary artery calcium, interstitial lung abnormalities, osteoporosis, and sarcopenia. Accordingly, herein we review current evidence on the prevalence, prognostic value, and clinical implications of such smoking-related findings in LCS, with a focus on the findings themselves, their relevance in patients with COPD, emerging technologies, and future directions for integration into screening protocols.