USPSTF issues final recommendation on AAA screening

The United States Preventive Services Task Force has published a final recommendation on screening elderly adults for abdominal aortic aneurysm (AAA). The statement was published online June 24 in the Annals of Internal Medicine.

The USPSTF recommends a one-time ultrasound screening for AAA for men ages 65 to 75 who have ever smoked--defined by the USPSTF as men who now smoke or who have smoked 100 cigarettes or more in the past.

As for men in that age range who have never smoked, the USPSTF concluded with "moderate certainty" that ultrasound screening provides a small net benefit. They recommended that clinicians selectively offer screening depending on "the balance of benefits and harms on the basis of evidence" pertaining to a patient's medical history, family history or other risk factors.

The final recommendations come six months after USPSTF altered its AAA recommendations in January.

"Older male smokers are at the highest risk of developing AAA," task force co-vice chair Albert Siu, M.D., said in an announcement following the publication of the draft recommendations. "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 far as women are concerned, the harms and benefits of screening are different, the USPSTF found. The task force is calling for more research to determine if AAA screening benefits women who smoke or have smoked and said it could not recommend either for or against such screening due to a lack of available research.

Elderly women who have never smoked have an extremely small chance of developing AAA (less than 1 percent). The USPSTF found that ultrasound screening is unlikely to benefit that population and that the harms of screening for AAA outweigh any potential benefits in women who have never smoked.

A AAA screening program using an electronic medical record can dramatically increase the number of abdominal ultrasound screening exams, as well as the detection of previously undiagnosed AAA, according to research published in February.

To learn more:
- read the statement in the Annals of Internal Medicine