This release includes four individual recommendations: 1) Recommends one-time screening for abdominal aortic aneurysm (AAA) by ultrasonography in men ages 65 to 75 years who have ever smoked (Grade B); 2) Recommends clinicians selectively offer screening for AAA in men ages 65 to 75 years who have never smoked (Grade C); 3) Insufficient evidence to assess the balance of benefits and harms of screening for AAA in women aged 65 to 75 who have ever smoked (Grade I); 4) Recommends against routine screening for AAA in women who have never smoked (Grade D). These recommendations update, though not substantially so, USPSTF’s 2005 recommendations for AAA screening.
The ACA requires private and public payers to expand coverage and reduce financial barriers for select preventive services, including preventive services receiving a Grade A or Grade B recommendation from the USPSTF. Since there was no change in Grade B recommendation for men ages 65 to 75 years who have ever smoked, it is not anticipated that payers change their coverage policies for AAA screening. Other organizations such as the American College of Cardiology, the American Heart Association, and the Society for Vascular Surgery tend to have wider recommendations, especially taking into account patient’s family history of AAA. Medicare currently offers AAA screening for beneficiaries who have a family history of AAA regardless of gender.
The USPSTF called for further research on women who smoke (currently Grade I) and validation of AAA risk scoring tools to help identify those most likely to benefit from screening. The USPSTF is likely to consider roles of other risk factors including family history for their next update.
Comments on the USPSTF draft recommendation are due Feb. 24.
To view the USPSTF’s recent Recommendation Statement, click here.