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USPSTF 2019 still recommends one-time AAA screening with US in men 65 years or older who have ever smoked (B recommendation)
Clinical Question
Should primary care clinicians offer screening for abdominal aortic aneurysm (AAA) in men 65 years or older who have ever smoked?
Bottom line
In this updated 2019 review, the U.S. Preventive Services Task Force recommends that primary care clinicians offer one-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked (B recommendation). The task force recommends selectively offering screening in men aged 65 to 75 years who have never smoked (C recommendation), and recommends against routine screening in women who have never smoked and have no family history of AAA. (D recommendation). Current evidence is insufficient to assess the balance of benefits and harms of screening in women aged 65 to 75 years who have ever smoked or have a family history of AAA (I statement). These recommendations are consistent with the 2014 USPSTF recommendation statements. Recommendation statements. 2c
Reference
Study design: Practice guideline
Funding: Government
Setting: Population-based
Synopsis
In this updated review, the task force found good evidence that a screening invitation to men aged 65 to 75 years resulted in a significantly reduced AAA-related mortality. However, no significant association with all-cause mortality benefit occurred. AAA is defined as aortic enlargement with a diameter of 3.0 cm or larger. Because of the potential harm from unnecessary intervention, surgical repair is standard practice for men with an AAA of 5.5 cm or larger in diameter or a AAA larger than 4.0 cm in diameter that has increased in size by at least 1.0 cm in a 1-year period. Although computed tomography is an accurate tool for identifying AAA, it is not recommended as a screening method because of the potential for harms from radiation exposure. The American College of Cardiology, the American Heart Association, and the American College of Preventive Medicine recommend one-time screening with ultrasonography in men aged 65 to 75 years who have ever smoked.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC