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U.S. Preventive Services Task Force recommendations for AAA screening

February 1, 2005

Gregorio A. Sicard, MD
President
Society for Vascular Surgery

Robert M. Zwolak, MD
Chair
SVS Government Relations Committee
 

The SVS commends the US Preventive Services Task Force for recognizing the value of ultrasound screening for abdominal aortic aneurysms (AAA). The Task Force recommendations are a major step in the right direction. Screening males over the age of 65 with a history of smoking will detect the majority of aneurysms before they rupture—saving thousands lives that are lost to this disorder every year. 

With the added weight of the Task Force recommendation, SVS and the other National Aneurysm Alliance members will redouble their efforts to gain Congressional passage of the SAAAVE bill – Screen Abdominal Aortic Aneurysms Very Efficiently. SAAAVE will provide a one-time ultrasound AAA screening benefit under Medicare Part B to identify this deadly disorder in at-risk individuals. SAAAVE was bill S2553 and HR4626 in the 108th Congress. It will be reintroduced for the 109th Congress in early February.

While SVS is extremely pleased that the Task Force recommended AAA screening for men who smoke, we are concerned about several aspects of their report. According to the Task Force, women and nonsmoking men with a positive family history for AAA do not merit screening despite the well documented high prevalence in these subgroups. In addition, the Task Force concluded that in women “screening and early treatment result in important harms,” and they recommend against screening any women for AAAs. While the prevalence of AAAs in women is certainly lower than in men, SVS has difficulty finding any documentation for the harms referred to by the Task Force. We believe the accurate conclusion is that there is insufficient evidence to make a decision regarding AAA screening in many subsets of women, and we strongly urge AAA screening in women who are sisters of known AAA patients.