USPSTF alters recommendations for AAA ultrasound screening

The United States Preventive Services Task Force (USPSTF) has updated its 2005 recommendation for ultrasound screening for abdominal aortic aneurysms (AAA), slightly changing its recommendations for both men and women.

With the new draft recommendation, USPSTF keeps its B-grade recommendation for screening of men between the ages of 65 and 75 who smoke or had smoked. And it now recommends selective screening for men of this age who never smoked, a change from its 2005 statement in which it made no recommendation for or against screening.

As for women of the same age, USPSTF concluded there to be insufficient evidence to determine the benefits or harms of screening those who have smoked--a change from the 2005 recommendation that those women shouldn't be screened. It's 2005 recommendation that women of that age who never smoked shouldn't be screening remains unchanged.

"Older male smokers are at the highest risk of developing AAA," Task Force co-vice chair Albert Siu, M.D., MSPH, said in an announcement. "The good news is that, if you are a 65- to 75-year-old man who smokes or used to smoke, one-time AAA screening with an ultrasound, along with appropriate treatment, can reduce your risk of dying from a rupture."

As for men who've never smoked, USPSTF recommends that they should talk to their doctor or nurse whether "one-time AAA screening might be right for them based on their health history and the potential benefits and harms of screening."

However, the benefits and harms for women from screening are different, the USPSTF reported, and called for more research to determine if AAA screening is beneficial for women ages 65 who smoke or who have smoked in the past. As for women who have never smoked, the chances of developing AAA are so low (less than 1 percent) that the USPSTF says screening is unlikely to be beneficial, and may actually be harmful.

The USPSTF based its new recommendations on a review of the evidence of the benefits and harms of ultrasound screening for AAA for asymptomatic individuals. The review, published online January 27 in the Annals of Internal Medicine, looked at the results of four population-based randomized, controlled trials.

Comments on the draft recommendation statement can be submitted to USPSTF until Feb. 24.

To learn more:
- see the USPSTF's new draft recommendation
- read the announcement from the USPSTF
- see the review in the Annals of Internal Medicine

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