Abstract
Update of the 2005 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for abdominal aortic aneurysm (AAA). The USPSTF commissioned a systematic review that assessed the evidence on the benefits and harms of screening for AAA and strategies for managing small (3.0 to 5.4 cm) screen-detected AAAs. These recommendations apply to asymptomatic adults aged 50 years or older. The USPSTF recommends 1-time screening for AAA with ultrasonography in men aged 65 to 75 years who have ever smoked. (B recommendation). The USPSTF recommends that clinicians selectively offer screening for AAA in men aged 65 to 75 years who have never smoked. (C recommendation). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for AAA in women aged 65 to 75 years who have ever smoked. (I statement). The USPSTF recommends against routine screening for AAA in women who have never smoked. (D recommendation).
Highlights
See the Clinical Considerations section for suggestions for practice regarding the I statement. These recommendations apply to asymptomatic adults aged 50 years or older
For the purposes of this recommendation, an “eversmoker” is a person who has smoked at least 100 cigarettes in his or her lifetime
A retrospective analysis from 2000 to 2010 used the National Inpatient Sample, a database that has a stratified 20% random sample of all nonfederal inpatient hospital admissions in the United States. This analysis found that women are more likely than men to have open surgery versus endovascular aneurysm repair (EVAR) for unruptured abdominal aortic aneurysm (AAA) (24% vs. 17%, respectively), potentially because of issues with access to the iliac artery that may preclude endovascular management (18)
Summary
The USPSTF commissioned a systematic review that assessed the evidence on the benefits and harms of screening for AAA and strategies for managing small (3.0 to 5.4 cm) screendetected AAAs. The USPSTF recommends that clinicians selectively offer screening for AAA in men aged 65 to 75 years who have never smoked. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for AAA in women aged 65 to 75 years who have ever smoked. The U.S Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific preventive care services for patients without related signs or symptoms. It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms
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