Offering cardiac CT scans as preventive service does not appear to save lives

November 5, 2025

Summary: Danish men over age 60 given an invitation to get a CT cardiac calcium score did not have lower mortality or fewer major cardiac events compared to men in a control group in a randomized clinical trial.

Source: Lindholt et al Eur Heart J August, 2025

A cardiac calcium score derived from a low-radiation CT scan predicts future cardiovascular risk. Those with elevated scores should aggressively manage risk factors such as smoking, high blood pressure, diabetes, and cholesterol. However, most health plans don’t cover the test, as the U.S. Preventive Services Task Force hasn’t recommended it for routine screening.

A randomized study published in the European Heart Journal invited Danish men ages 60–64 to undergo CT cardiac screening. After seven years, there was no significant mortality benefit in the population invited to the screening.

Implications for employers:

• There’s currently insufficient evidence to justify covering calcium scoring as a standard preventive benefit in the general population with average risk of heart disease.

• Calcium scores are commonly included in executive physicals, but clinical benefit remains uncertain. There may be a role for this test in patients at higher risk of a cardiac event.

• Regardless of test results, controlling blood pressure, blood sugar, and cholesterol remains essential for all plan members.

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