A 67-year-old man visits his primary care physician for a routine health maintenance examination. He has no active complaints. His past medical history includes hypertension and hyperlipidemia, both well-controlled on daily medications. He smoked one pack of cigarettes daily from age 20 to age 50 but successfully quit 17 years ago. He drinks alcohol occasionally. Vital signs are within normal limits. Physical examination, including a careful abdominal examination, is unremarkable. A review of his medical records reveals he has not received any preventive screening for abdominal conditions. Which of the following is the most appropriate recommendation regarding screening for an abdominal aortic aneurysm in this patient?
- One-time screening with abdominal ultrasonographyAnswer
- BAnnual screening with abdominal ultrasonography
- COne-time screening with computed tomography of the abdomen
- DScreening is not indicated because he lacks a family history of the condition
- EScreening is not indicated because he quit smoking more than 15 years ago
Answer
The most appropriate recommendation is a one-time screening with abdominal ultrasonography.
The correct recommendation is a one-time screening with abdominal ultrasonography. According to the United States Preventive Services Task Force (USPSTF), men aged 65 to 75 years who have ever smoked (defined as having smoked at least 100 cigarettes in their lifetime) should undergo a one-time ultrasound to screen for an abdominal aortic aneurysm (AAA). This patient is 67 years old and has a significant smoking history, making him a prime candidate. Detecting an AAA before it ruptures significantly reduces mortality.
Step-by-Step Solution
Key Concept
USPSTF guidelines recommend one-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked.