Aneurysm Screening for Smokers Over 65

US Preventive Services Task Force recommends screening of male smokers to identify some types of aneurysms

(RxWiki News) Abdominal aortic aneurysms can be a serious, even deadly ailment. A medical task force has recently released new recommendations for screenings that can save lives.

The US Preventive Services Task Force (USPSTF) updated the existing 2005 recommendations for abdominal aortic aneurysm screening based on supporting scientific evidence.

The USPSTF now recommends that every man between the age of 65 and 75 who now or in the past has smoked should be screened for an abdominal aortic aneurysm.

The USPSTF further concluded that screening men ages 65 to 75 who have never smoked should be considered with regard to medical history, family history and other factors. 

There was insufficient evidence to determine the benefits and harms of screening women aged 65 to 75 who had ever smoked for abdominal aortic aneurysm.

"Stop smoking now to lower your risk of heart-related problems."

The USPSTF looked at four large randomized trials related to abdominal aortic aneurysms.

The USPSTF explained that an abdominal aortic aneurysm is the presence of an unusually large (greater than 3 cm) or ballooning of the aorta (the largest artery in the body carrying blood away from the heart) in the abdomen. Experts estimate that approximately 9,000 deaths occur annually in the United States due to abdominal aortic aneurysms.

This task force noted that screening is important for the highest at-risk group because most abdominal aortic aneurysms go undetected until they rupture. The risk of death after an abdominal aortic aneurysm ruptures is between 75 percent and 90 percent.

The USPSTF research showed that an abdominal aortic aneurysm is expected in 7 percent of men between 65 and 75 who ever smoked. The USPSTF recommended men in this group get a screening for an abdominal aortic aneurysm, as they believe the risk outweighs any potential negative effects.

The same USPSTF research found that men who never smoked had a 2 percent or lower risk of abdominal aortic aneurysm. Therefore, the USPSTF recommended that patients and doctors should discuss the risks and benefits for screening based on factors relevant to the patient’s medical history, family history and other potential risk factors.

The USPSTF recommended against routine screening for abdominal aortic aneurysm in women who have never smoked. There was insufficient evidence to make a recommendation for screening in women who had ever smoked. 

Screening for an abdominal aortic aneurysm consists of a simple, noninvasive ultrasound, which costs about $100. The USPSTF also listed the potential associated cost of elective surgery to repair an abdominal aortic aneurysm between $37,000 and $43,000.

The USPSTF currently recommends immediate surgery for abdominal aortic aneurysms measuring 5.5 cm and larger. Smaller abdominal aortic aneurysms generally require long-term monitoring.

This recommendation was published January 27 in the Annals of Internal Medicine.

Review Date: 
January 23, 2014