Screening for abdominal aortic aneurysm

The Preventive Care Checklist Form^© update by Duerksen et al in the January 2012 issue¹ is an excellent summary of preventive care that would be useful for any family physician. One cannot help but notice the paucity of evidence behind many of the actions undertaken at the annual health checkup.

An area of preventive medicine that is often overlooked is the screening for abdominal aortic aneurysms (AAAs). The evidence behind 1-time AAA screening for select populations (eg, male smokers aged 65 to 75 years) is equivalent to, if not better than, the evidence behind many of the strongest recommendations in this form. Consequently, select AAA screening has been supported by the US Preventive Services Task Force,² the Canadian Society for Vascular Surgery,³ and the Ontario Health Technology Advisory Committee.⁴ Despite being cost effective and potentially lifesaving, the 1-time ultrasound has not been adopted for routine screening by the Canadian Task Force on Preventive Health Care—possibly because the last position statement was published in 1991.⁵

It might be prudent to include a reminder for selective AAA screening in the next version of the Preventive Care Checklist Form.

• Copyright© the College of Family Physicians of Canada