USPSTF: Screen Some, Not All, for Abdominal Aortic Aneurysm

All men between the ages of 65 and 75 years old who have ever smoked should undergo 1-time screening for abdominal aortic aneurysm (AAA) with ultrasonography, according to a new recommendation from the United States Preventive Services Task Force. 

The recommendation—updating a 2005 recommendation on AAA screening—is the result of a systematic review of the benefits and harms of AAA screening and strategies for their management. 
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The biggest change to the guideline in its latest update is an “I Statement” declaring current evidence insufficient in assessing the benefits and harms of AAA screening in women 65 years and older who have ever smoked. The previous 2005 guideline advised against screening in this group.

Among other updates was the recommendation that clinicians offer selective screening for AAA in men over 65 years old who have never smoked, using the patient’s medical and family history, risk factors, and personal values to determine when screening is appropriate.

It also recommends against routine screening in women over 50 years old who have never smoked.

The USPSTF stressed that “more research—including high-quality modeling studies—is required to better understand the relative benefits and harms of screening for AAA in men and women with a family history of AAA and for women who have ever smoked.”

–Michael Potts

LeFevre ML. Screening for abdominal aortic aneurysm: U.S. preventive services task force recommendation statement. Ann Intern Med. 2014 June 24 [epub ahead of print]doi:10.7326/M14-1204