Screening for Abdominal Aortic Aneurysm From the U.S. Preventive Services Task Force January, 2005 What Does the U.S. Preventive Services Task Force Recommend? What Are the Risk Factors? What Are the Potential Benefits of Screening and Treatment? What Does the U.S. Preventive Services Task Force Recommend? The U.S. Preventive Services Task Force (USPSTF) recommends one-time screening for abdominal aortic aneurysm by abdominal ultrasonography for men between the ages of 65 and 75 who have ever smoked (ie, at least 100 cigarettes during one's lifetime). The USPSTF makes no recommendation for or against screening for abdominal aortic aneurysm in men between the ages of 65 and 75 who have never smoked. The USPSTF recommends against routine screening for abdominal aortic aneurysm in women. What Are the Risk Factors? Being male, 65 or older, and ever having smoked are the major risk factors for abdominal aortic aneurysm. A first-degree family history of abdominal aortic aneurysm requiring surgical repair also elevates a man's risk for this condition; this may also be true for women but the evidence is less certain. What Are the Potential Benefits of Screening and Treatment? Screening for abdominal aortic aneurysm and open surgical repair of abdominal aortic aneurysms of 5.5 cm or more in older men leads to an estimated 43% reduction in mortality from abdominal aortic aneurysm. In men with abdominal aortic aneurysms of 4.0 to 5.4 cm, periodic surveillance, combined with elective surgery in those whose abdominal aortic aneurysm has progressed, offers comparable mortality benefit to routine elective surgery. Currently, there is no evidence to support any intervention in those with small abdominal aortic aneurysms (3.0-3.9 cm), although some expert opinion-based recommendations favor annual ultrasonography for these patients. The potential benefit of screening for abdominal aortic aneurysm among women aged 65 to 75 is low due to the small number of deaths related to this condition in this population. A clinician may, however, choose to discuss screening in unusual circumstances, such as in the case of a healthy female smoker in her early 70s who has a first-degree family history for abdominal aortic aneurysm that required surgery One-time screening using ultrasonography is sufficient to detect abdominal aortic aneurysm, since new abdominal aortic aneurysm is extremely rare in persons with an initial negative result. Abdominal ultrasonography is an accurate screening test for abdominal aortic aneurysm if it is performed in a setting with adequate quality assurance (ie, an accredited facility with credentialed technologists). Screening for abdominal aortic aneurysm should be reserved for those who have a reasonable probability of having an abdominal aortic aneurysm large enough to benefit from surgery and for those who have a reasonable life expectancy.