Guideline recommends screening with ultrasound for men aged 65-80 but not for men over 80 years of age or women
OTTAWA, ON, September 11, 2017 –The Canadian Task Force on Preventive Health Care’s (CTFPHC) new screening guideline for abdominal aortic aneurysm (AAA) recommends one-time screening with ultrasound for AAA for men aged 65-80. AAA screening is not recommended for women or men older than 80 years of age.
An AAA is a swelling (aneurysm) of the aorta which is the main blood vessel that leads away from the heart, down through the abdomen to the rest of the body. Each year, an estimated 20,000 Canadians are diagnosed with an AAA and approximately 1,244 annual deaths are attributed to this disorder. Screening is undertaken by ultrasound, a convenient and dependable tool that successfully identifies potential problem areas in the aortic wall.
“The prevalence of AAA among men aged 65 to 80 is reported to be four to five times higher than in women of the same age. Women are unlikely to benefit from being screened for AAA” said Dr. Harminder Singh, member of the Task Force and chair of the guideline working group. “The benefit of screening men over 80 years of age is likely to be lower than in younger men, due to their greater risk from interventions to repair an AAA.”
These recommendations were published today in the Canadian Medical Association Journal (CMAJ). The CTFPHC makes the following screening recommendations for AAA:
- One-time screening with ultrasound for abdominal aortic aneurysm for men aged 65 to 80. (Weak recommendation; moderate quality of evidence)
- Not screening men older than 80 years of age for abdominal aortic aneurysm. (Weak recommendation; low quality of evidence)
- Not screening women for abdominal aortic aneurysm. (Strong recommendation; very low quality of evidence)
“Primary care providers should be watchful about risk factors for those susceptible to AAA including smoking, advanced age, and family history of AAA. Coronary artery disease, atherosclerosis, hypercholesterolemia, and hypertension are also associated with AAA,” said Dr. Gabriela Lewin member of the Task Force guideline working goup.
AAA and Smoking
Despite evidence showing increased risk of development and growth of AAA among smokers, the CTFPHC did not make a separate recommendation on screening in this population. This is because no evidence is available on the health outcomes (benefits and harms) of screening smokers for AAA. In general, risks of intervention to repair an AAA are greater among smokers.
For the complete report and details on the CTFPHC’s findings and recommendations and accompanying clinician and patient knowledge translation tools, please visit: www.canadiantaskforce.ca
This Clinical Practice Guideline has been endorsed by the Nurse Practitioners’ Association of Canada (NPAC).
About the Canadian Task Force on Preventive Health Care
The Canadian Task Force on Preventive Health Care (CTFPHC) has been established to develop clinical practice guidelines that support primary care providers in delivering preventive health care. The mandate of CTFPHC is to develop and disseminate clinical practice guidelines for primary and preventive care, based on systematic analysis of scientific evidence.