Clinical Edge

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Screening for Abdominal Aortic Aneurysm in Older Men

Circulation; 2016 Oct 18; Wanhainen, et al

Publish date:

Confirming earlier randomized controlled trials, screening men aged 65 years for abdominal aortic aneurysm (AAA) proved an effective preventive health measure and highly cost-effective in a contemporary setting, a recent study showed. A nationwide AAA screening program invited 302,957 men aged 65 years to participate; 84% attended. Researchers found:

  • Prevalence of screening-detected AAA was 1.5%.
  • 29% of patients with AAA had been operated on, with a 30-day mortality rate of 0.9%, after a mean of 4.5 years.
  • The introduction of screening was associated with a significant reduction in AAA-specific mortality (mean, 4.0% per year of screening).
  • 90 premature deaths were estimated as being annually prevented.

Citation:

Wanhainen A, Hultgren R, Linne A, et al. Outcome of the Swedish nationwide abdominal aortic aneurysm screening program. Circulation. 2016;134:1141-1148. doi:10.1161/CIRCULATIONAHA.116.022305.

Commentary:

This study supports the US Preventive Services Task Force recommendations for screening for abdominal aortic aneurism1 which are:

  • Men Ages 65 to 75 Years Who Have Ever Smoked: The USPSTF recommends one-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked.
  • Men Ages 65 to 75 Years Who Have Never Smoked: The USPSTF recommends that clinicians selectively offer screening for AAA in men aged 65 to 75 years who have never smoked rather than routinely screening all men in this group.
  • Women Ages 65 to 75 Years Who Have Ever 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.
  • Women Who Have Never Smoked: The USPSTF recommends against routine screening for AAA in women who have never smoked. —Neil Skolnik, MD
  1. US Preventive Services Task Force. USPSTF Web site. Abdominal Aortic Aneurysm: Screening. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/abdominal-aortic-aneurysm-screening.

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