The USPSTF released a new recommendation regarding screening for AAA
The USPSTF recommends one-time screening for abdominal aortic aneurysm (AAA) by ultrasonography in men aged 65 to 75 who have ever smoked.Rating: B Recommendation.
Rationale: The USPSTF found good evidence that screening for AAA and surgical repair of large AAAs (5.5 cm or more) in men aged 65 to 75 who have ever smoked (current and former smokers) leads to decreased AAA-specific mortality. There is good evidence that abdominal ultrasonography, performed in a setting with adequate quality assurance (i.e., in an accredited facility with credentialed technologists), is an accurate screening test for AAA. There is also good evidence of important harms of screening and early treatment, including an increased number of surgeries with associated clinically-significant morbidity and mortality, and short-term psychological harms. Based on the moderate magnitude of net benefit, the USPSTF concluded that the benefits of screening for AAA in men aged 65 to 75 who have ever smoked outweigh the harms.
The USPSTF makes no recommendation for or against screening for AAA in men aged 65 to 75 who have never smoked.
Rating: C Recommendation.
Rationale: The USPSTF found good evidence that screening for AAA in men aged 65 to 75 who have never smoked leads to decreased AAA-specific mortality. There is, however, a lower prevalence of large AAAs in men who have never smoked compared with men who have ever smoked; thus, the potential benefit from screening men who have never smoked is small. There is good evidence that screening and early treatment leads to important harms, including an increased number of surgeries with associated clinically-significant morbidity and mortality, and short-term psychological harms. The USPSTF concluded that the balance between the benefits and harms of screening for AAA is too close to make a general recommendation in this population.
The USPSTF recommends against routine screening for AAA in women.
Rating: D Recommendation.
Rationale: Because of the low prevalence of large AAAs in women, the number of AAA-related deaths that can be prevented by screening this population is small. There is good evidence that screening and early treatment result in important harms, including an increased number of surgeries with associated morbidity and mortality, and psychological harms. The USPSTF concluded that the harms of screening women for AAA outweigh the benefits.
A quick scan of the headlines reveals that most of the newspapers gets it right. However, there are some offenders that don’t: Panel calls for screenings for abdominal aneurysms, which wrongly implies mass public screenings.
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- Should prostate cancer screening stop after the age of 75?
- Early cancer screening isn’t always better
- When women should have their first Pap smear; the new cervical cancer screening guidelines
- Should tobacco companies pay for smokers’ CT scans to screen for lung cancer?
- A doctor who advocates no screening tests
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