USPSTF Recommends (Again) Against Screening for Carotid Artery Stenosis in Asymptomatic Patients

Background

In 2014, the USPSTF recommended against general population screening for carotid artery stenosis in patients without prior stroke or ischemic attack (NEJM JW Gen Med Sep 15 2014 and Ann Intern Med 2014; 161:356). The Task Force has now updated its guideline.

Key Points

• Because evidence shows with moderate certainty that harms of screening for carotid artery stenosis in the asymptomatic general population outweigh benefits, the USPSTF reaffirms its recommendation against screening (D recommendation).

• Duplex ultrasonography has reasonable sensitivity and specificity for diagnostic evaluation of symptomatic patients, but poor positive predictive value for screening asy…