-USPSTF recommends one-time screening for AAA with ultrasonography in men ages 65 to 75 years who have ever smoked. Grade B
-For men 65-75 who have never smoked? The USPSTF recommends that clinicians selectively offer screening for AAA in men ages 65 to 75 years who have never smoked rather than routinely screening all men in this group. Grade C.
-USPSTF gives a Grade I for screening women Ages 65 to 75 Years who Have Ever Smoked.
-USPSTF gives a grade D for women who have never smoked – They say, Don’t do it.
“Smoking history (at least 100 cigarettes in a lifetime) and male sex are the major risk factors for abdominal aortic aneurysm (AAA). The U.S. Preventive Services Task Force (USPSTF) recommends one-time screening for AAA by ultrasonography between the ages of 65 and 75 in men who have ever smoked (USPSTF B recommendation). The USPSTF also recommends that clinicians selectively offer screening for AAA in men in this age group who have never smoked if indicated by the patient’s medical history, family history, other risk factors, and personal values (USPSTF C recommendation). Important risk factors in addition to age include a first degree relative with AAA. Other risk factors to take into account include a history of other vascular aneurysms, coronary artery disease, cerebrovascular disease, atheroslcerosis, hypercholesterolemia, obesity, and hypertension.
The greatest likelihood of finding an AAA large enough to benefit from surgery is between the ages of 65 and 75. In patients older than 75, the likelihood of surviving surgery to repair an AAA is low enough to preclude screening. The benefit of screening for women in this age group is low due to the low number of AAA-related deaths in this population (SOR B). The USPSTF recommends against routine screening for AAA in women (USPSTF D recommendation).
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