Highlights
- •AAA screening rate was 6.9% among 6,682 eligible patients with 1 year of follow-up in this retrospective observational study.
- •Black patients had lower odds of receiving screening compared to white patients.
- •Although PCP visit is the most consistent predictor of screening, provider screening rates are low.
- •Screening for AAA per USPSTF guidelines is underutilized with evidence of a racial disparity.
Objectives
The US Preventive Services Task Force (USPSTF) recommends a 1 time screening for AAA
with ultrasonography in men aged 65-75 who have ever smoked. Our objectives were to
identify the AAA screening rates in a large academic health system and assess factors
associated with receipt of screening.
Methods
Data were extracted from electronic health records from the Duke University Health
System and the US Census Bureau. Index screening eligibility date was defined as the
65th birthdate for male patients with a history of smoking. Patients with an index
screening eligibility date between January 1, 2016 and December 31, 2018 were included
in the study population and followed through December 31, 2019. Screened patients
were identified by procedure codes for ultrasonography, CT or MRI.
Results
Among 6,682 eligible patients who turned 65 years old between January 1, 2016 and
December 31, 2018 with at least 1 year of follow-up, only 463 (6.9%) received AAA
screening during the study period. The odds of receiving AAA screening within 1 year
of index eligibility were 27% lower for Black patients compared to whites [OR = 0.73,
95% CI (0.58,0.93)]. Patients who visited a PCP or were diagnosed with hypertension
had 75% and 41% greater odds of receiving screening, respectively [OR 1.75, 95% CI
(1.36,2.25)] and [OR 1.41 95% CI (1.11,1.80)] compared with patients who did not.
Among 4,580 men with 2 years of follow-up, AAA screening rate increased to 13.0%.
Patients who visited a PCP had 64% greater odds of receiving screening within 2 years
of index eligibility compared to those who did not [OR = 1.64, 95% CI (1.30,2.06)].
Conclusions
Screening for AAA per USPSTF guidelines is underutilized with evidence of a racial
disparity. Although PCP visit is the most consistent predictor of screening, provider
screening rates are low.
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Article Info
Publication History
Published online: December 20, 2021
Accepted:
November 29,
2021
Received in revised form:
November 18,
2021
Received:
October 26,
2021
Footnotes
The Authors have no conflict of interest to disclose.
Identification
Copyright
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