Screening for Abdominal Aortic Aneurysm: US Preventive Services Task Force Recommendation Statement.

Area of Science:

• Vascular Surgery
• Preventive Medicine
• Diagnostic Imaging

Background:

• Abdominal aortic aneurysm (AAA) is defined as aortic enlargement ≥3.0 cm.
• AAA prevalence has declined in screened European men but is unclear in the US due to low screening uptake.
• Ruptured AAAs carry an 81% mortality risk, with most AAAs being asymptomatic until rupture.

Purpose of the Study:

• To update 2014 recommendations on AAA screening.
• To review evidence on screening effectiveness, harms, and treatment benefits for small AAAs.

Main Methods:

• Evidence review commissioned by the USPSTF.
• Focused on 1-time and repeated screening for AAA.
• Considered benefits and harms of treating small AAAs (3.0-5.4 cm).

Main Results:

• Moderate net benefit for AAA screening in men aged 65-75 who ever smoked.
• Small net benefit for screening in men aged 65-75 who never smoked.
• Insufficient evidence for screening in women aged 65-75 who smoked or had a family history.

Conclusions:

• Recommend 1-time AAA screening via ultrasonography for men 65-75 who ever smoked (B recommendation).
• Selectively offer screening to men 65-75 who never smoked (C recommendation).
• Recommend against routine screening for women 65-75 who never smoked and have no family history (D recommendation).