Asymptomatic men aged 65 to 75 years who have ever smoked should have a one-time screening with ultrasonography for abdominal aortic aneurysm (AAA), according to a new recommendation statement from the United States Preventive Services Task Force that is being published in Annals of Internal Medicine.
Physicians should selectively offer screening for AAA in men aged 65 to 75 who have never smoked based on assessment of the balance of benefits and harms and individual patient risk factors. Risk factors for AAA include advanced age, male sex, smoking, and a family history, with smoking being the most important modifiable risk factor.
The Task Force recommends against routine screening for AAA in women who have never smoked and found insufficient evidence to recommend for or against screening women aged 65 to 75 years who have ever smoked. AAA is a weakening in the wall of the abdominal section of the aorta resulting in localized dilation, or ballooning, that is at least three centimeters - or about an inch - wide. A large proportion of AAAs are asymptomatic until a rupture develops, which is generally acute and often fatal. An evidence review showed that screening male smokers for AAA is associated with decreased AAA rupture and AAA-related mortality rates.