Abdominal Aortic Aneurysm: Screening
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
|Population||Men ages 65 to 75 years who have ever smoked*||Men ages 65 to 75 years who have never smoked*||Women ages 65 to 75 years who have ever smoked||Women who have never smoked|
|Recommendation||Screen once for abdominal aortic aneurysm (AAA) by ultrasonography.
|Selectively screen for AAA.
Grade: I statement
|Do not screen for AAA.
|Risk Assessment||Risk factors for AAA include older age; a positive smoking history; having a first-degree relative with an AAA; and having a history of other vascular aneurysms, coronary artery disease, cerebrovascular disease, atherosclerosis, hypercholesterolemia, obesity, or hypertension.
Factors associated with a reduced risk for AAA include African American race, Hispanic ethnicity, and diabetes.
|Screening Tests||Abdominal duplex ultrasonography is the standard approach for AAA screening. Screening with ultrasonography is noninvasive and easy to perform and has high sensitivity (94% to 100%) and specificity (98% to 100%) for detection.|
|Treatment||Patients with large AAAs (≥5.5 cm) are referred for open surgical repair or endovascular aneurysm repair. Patients with smaller aneurysms (3.0 to 5.4 cm) are generally managed conservatively via surveillance (e.g., repeated ultrasonography every 3 to 12 months). Early open surgery for the treatment of smaller AAAs does not reduce AAA-specific or all-cause mortality. Surgical referral of smaller AAAs is typically reserved for rapid growth (>1.0 cm per year) or once the threshold of ≥5.5 cm on repeated ultrasonography is reached.
Short-term treatment with antibiotics or β-blockers does not appear to reduce AAA growth.
|Balance of Benefits and Harms||There is a moderate net benefit of screening for AAA with ultrasonography in men ages 65 to 75 years who have ever smoked.||There is a small net benefit of screening for AAA with ultrasonography in men ages 65 to 75 years who have never smoked.||The evidence of screening for AAA in women ages 65 to 75 years who have ever smoked is insufficient, and the balance of benefits and harms cannot be determined.||The harms of screening for AAA in women who have never smoked outweigh any potential benefits.|
|Other Relevant USPSTF Recommendations||These recommendations are available at http://www.uspreventiveservicestaskforce.org.|
* ”Ever smoked” is defined as a person who has smoked at least 100 cigarettes in his or her lifetime.
For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.
Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Internet Citation: Clinical Summary: Abdominal Aortic Aneurysm: Screening. U.S. Preventive Services Task Force. September 2016.