What's New An independent federal advisory panel last week advised that all men between 65 and 75 who have ever smoked be tested for abdominal aortic aneurysm. This ballooning of the major artery that supplies blood from the heart to the rest of the body kills some 9,000 people a year, most of them men over 65, according to the Agency for Healthcare Research and Quality, which sponsored the panel. The recommendation, targeting some 10 million Americans, was published in the Feb. 1 issue of the Annals of Internal Medicine.
Background Abdominal aortic aneurysm can be deadly if the aortic bulge ruptures: an estimated 59 to 83 percent of patients with such a rupture die before reaching the hospital. But the risks of medical intervention to repair intact aneurysms must be weighed against the fact that only about one in 10 aneurysms will ever rupture, said task force chairman Ned Colonge, chief medical officer of the Colorado Department of Public Health and Environment. Surgical repair, the most common treatment option, is a major invasive procedure prone to cardiac and pulmonary complications. Stenting is a less invasive alternative, but its long-term efficacy still is being studied.
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The Findings The recommended test -- a short, painless ultrasound procedure -- will prevent one death every five years for every 500 such men screened, according to Colonge. Surgery will generally be advised, he said, for patients with symptoms or aneurysms larger than five centimeters.
Colonge said screening was not recommended for women, for nonsmokers or for men under 65 or over 75 who had smoked, because treatment risks outweigh benefits for these groups.
What's Next Ultrasound screening for abdominal aortic aneurysm costs about $350 per test. Until now, it has not generally been covered as a routine screening by private health insurance or Medicare. The advisory panel's recommendations may prompt insurers to review that policy, Colonge said.
-- Rita Zeidner