I have been reading up on the subject of ultrasound screening for AAA.
Although the RACGP red book places screening via Abdominal US with the group of tests that are of little benefit I feel that there are subgroups of patients in the 65-75 year age group (male , ex/smoker) that are at higher risk and the red book blanket statement could be 'fine tuned'.
www.racgp.org.au/redbook/15
(based on the study found here www.bmj.com/highwire/filestream/39815...
After having read through the the reference quoted in the Red Book (above) I noted that the author/s added several caveats to the interpretation of the results eg high background level of detection within control population, ineligible targets, age group extended to 85 in the study, poor attendence to screening in electoral role based population study (vs GP prompted preventive care activity).
You should draw your own conclusions after reading through the facts. I wont add it to the DCP prompts but will keep it in mind.
The USPSTF recommendation is as follows :
One-time screening for abdominal aortic aneurysm (AAA) by ultrasonography in men aged 65-75 years is associated with a significant reduction in AAA-related mortality (odds ratio, 0.56 [95% CI, 0.44 to 0.72]). With long-term (7-15 years) follow-up, the reduction in AAA-related mortality is sustained, and screening appears to produce a reduction in all-cause mortality (OR = 0.94, 95% CI 0.92, 0.97). Women do not appear to benefit from screening, and most of the benefit in men appears to accrue among current or former smokers. Recent analyses suggest that screening men aged 65 years and older is highly cost-effective.
Screening for abdominal aortic aneurysm
Recommends one-time screening for abdominal aortic aneurysm (AAA) by ultrasonography in men aged 65 to 75 who have ever smoked. (B)
No recommendation for or against screening for AAA in men aged 65 to 75 who have never smoked. (C)
Recommends against routine screening for AAA in women. (D)
Summary of Evidence Support level
Recommendation A: The USPSTF strongly recommends that clinicians routinely provide the service to eligible
patients. (The USPSTF found good evidence that the service improves important health outcomes and concludes
that benefits substantially outweigh harms.)
Recommendation B: The USPSTF recommends that clinicians routinely provide the service to eligible patients. (The
USPSTF found at least fair evidence that the service improves important health outcomes and concludes that benefits
substantially outweigh harms.)
Recommendation C: The USPSTF makes no recommendation for or against routine provision of the service.
Recommendation D: The USPSTF recommends against routinely providing the service to asymptomatic patients. (The
USPSTF found at least fair evidence that the service is ineffective or that harms outweigh benefits.)
Recommendation I: The USPSTF concludes that the evidence is insufficient to recommend for or against routinely providing
the service.
http://www.uspreventiveservicestaskfo...