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February 2, 2021

Screening for Asymptomatic Carotid Artery Stenosis: Lack of Clinical Benefit, Potential for Harm

Author Affiliations
  • 1Department of Neurology, Kentucky Neuroscience Institute, University of Kentucky, Lexington
JAMA. 2021;325(5):443-444. doi:10.1001/jama.2020.26440
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In the Recommendation Statement published in this issue of JAMA,1 the US Preventive Services Task Force (USPTF) has reaffirmed its 2014 recommendation, stating that “The USPTF recommends against screening for asymptomatic carotid artery stenosis in the general adult population (D recommendation),” based on evidence that the harms of screening for carotid artery stenosis in asymptomatic adults outweigh the benefits, with no new evidence that would change the previous recommendation. The rationale for this confirmation is based on a combination of considerations, including the effects of false-positive results when screening the general population with duplex ultrasonography; inadequate evidence that screening for asymptomatic carotid artery stenosis leads to a reduction in stroke or death; and the likelihoods of small to moderate harms of screening for and treatment of asymptomatic carotid artery stenosis. The restated recommendation is also consistent with that of the 2014 guidelines from the American Heart Association not to screen low-risk populations for asymptomatic carotid artery stenosis.2