USPSTF Advises Against Carotid Artery Stenosis Screening
(HealthDay News) — The US Preventive Services Task Force (USPSTF) recommends against screening for asymptomatic carotid artery stenosis (CAS) in the general adult population, according to a draft recommendation statement published online February 17.
Researchers from the USPSTF conducted a systematic review of the current evidence on the benefits and harms of screening for CAS in asymptomatic adults. The researchers found that the most feasible screening test for CAS is ultrasonography, which yields many false positive results in the general population. No direct evidence was found for the benefits of CAS screening. For selected trial participants with CAS, carotid endarterectomy reduces the absolute incidence of all strokes or perioperative death compared with medical management (about 3.5% reduction), but the magnitude of these benefits is likely to be smaller in the general population.
These findings form the basis of a draft recommendation statement against screening for asymptomatic CAS in the general population (Grade D recommendation), which is available for comment from February 18–March 17, 2014.
"CAS is uncommon in the general adult population, so screening everyone would lead to many false positive results, and this can lead to follow-up tests and surgery that carry risk of serious harms, including stroke, heart attack, and death," Task Force member Jessica Herzstein, MD, MPH, said in a statement.