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Invited Commentary
December 2016

The Last (Randomized) Word on Screening for Abdominal Aortic Aneurysms

Author Affiliations
  • 1Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota
JAMA Intern Med. 2016;176(12):1767-1768. doi:10.1001/jamainternmed.2016.6663

The long-term follow-up of the Western Australian trial of screening for abdominal aortic aneurysms (AAAs) reported in this issue of JAMA Internal Medicine1 is likely the last report from the 4 randomized clinical trials1-4 of AAA screening and the end of an era that began with the Chichester, United Kingdom, trial2 in 1989. Earlier combined results from the 4 trials found that screening with ultrasonography reduced AAA-related mortality in older men by more than 40% and led to the 2005 recommendation by the US Preventive Services Task Force (USPSTF) for 1-time ultrasonographic screening for AAAs in men 65 to 75 years old who have ever smoked. Since then, a meta-analysis5 that incorporated longer follow-up from these trials has strengthened the case for screening, revealing increasing benefit and cost-effectiveness.

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