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Abdominal aortic aneurysm screening

An abdominal aortic aneurysm (AAA) is a bulge in the main artery in the belly. The USPSTF gives a one-time ultrasound a grade B for men 65 to 75 who have ever smoked. (USPSTF, 2019)

USPSTF grade
B
Who
Men, if at risk
Ages
65 to 75
How often
Once

When it starts, when it can stop

  • Starts: At 65, for men who have ever smoked. (USPSTF, 2019)
  • Can stop: It is a one-time test, and the grade B range ends at 75. (USPSTF, 2019)

Who it is for

Men aged 65 to 75 years who have ever smoked, meaning 100 or more cigarettes in their life. (USPSTF, 2019)

In My Screening Plan this shows up when you tick: I have smoked 100 or more cigarettes in my life.

Test and how often

AAA ultrasound: who, when, how often

Abdominal aortic aneurysm screening at 65 to 75: USPSTF 2019 and Medicare
Who (65 to 75)USPSTF (2019)Medicare Part B
Men who have ever smokedScreen once (grade B)Once in your lifetime, with a referral
Men who never smokedOffer selectively (grade C)Only with a family history of AAA
Women who ever smoked or have a family historyEvidence insufficient (grade I)Only with a family history of AAA
Women who never smoked, no family historyDo not screen (grade D)Not on the Medicare risk list

The USPSTF calls for one ultrasound, not a series. Medicare matches that: once in your lifetime, with a referral, if you are at risk, and you pay nothing if the provider accepts assignment. (USPSTF, 2019) (Medicare.gov)

Medicare counts a family history of AAA as a risk for anyone, which is wider than the USPSTF grade B group of men who have smoked. (Medicare.gov)

If you think you qualify, ask your doctor for a referral.

Where the USPSTF draws the line

Grade C means a small net benefit, so it is offered to some people; D means do not screen; I means the evidence is not enough to decide. (USPSTF grade definitions)

  • Grade C: for men 65 to 75 who have never smoked, offer screening selectively rather than to all. (USPSTF, 2019)
  • Grade I: the evidence is not enough to weigh screening women 65 to 75 who have ever smoked or have a family history of AAA. (USPSTF, 2019)
  • Grade D: do not screen women who have never smoked and have no family history of AAA. (USPSTF, 2019)

Questions people ask

Who should get screened for an abdominal aortic aneurysm?

Men 65 to 75 who have ever smoked: the USPSTF recommends a one-time ultrasound (grade B). "Ever smoker" is commonly defined as smoking 100 or more cigarettes. (USPSTF, 2019)

Should men who never smoked get an AAA ultrasound?

Not routinely. For men 65 to 75 who have never smoked, the USPSTF recommends that clinicians "selectively offer screening" rather than screen all of them (grade C), weighing medical history, family history, other risk factors and personal values. (USPSTF, 2019)

Should women get screened for AAA?

For women who have never smoked and have no family history of AAA, the USPSTF recommends against routine screening (grade D). For women 65 to 75 who have ever smoked or have a family history of AAA, it says the evidence is insufficient to weigh benefits and harms (grade I), so it is a question to raise with your clinician. (USPSTF, 2019)

Does a family history of aortic aneurysm matter?

Yes. The USPSTF lists older age, male sex, smoking and a first-degree relative (parent, sibling or child) with an AAA as risk factors. In 2019 it added family history as a factor in screening decisions for women. (USPSTF, 2019)

How often is AAA screening done?

Once. The USPSTF recommendation is a one-time ultrasound. If an aneurysm is found, the next steps depend on its size, the risk of rupture and the risks of surgery. (USPSTF, 2019)

What size is an aortic aneurysm?

The USPSTF says an AAA is typically defined as an aorta 3.0 cm or wider. It notes that surgical repair is standard for men with an AAA of 5.5 cm or larger, or one larger than 4.0 cm that grew 1.0 cm or more in a year. (USPSTF, 2019)

Does Medicare pay for AAA screening?

Medicare Part B covers one ultrasound in your lifetime, with a referral, if you are at risk: a family history of abdominal aortic aneurysm, or a man 65 to 75 who has smoked at least 100 cigarettes. You pay nothing if the provider accepts assignment. (Medicare.gov)

If my AAA ultrasound is normal, do I need another one?

The USPSTF says the evidence supports a single scan for men who have ever smoked. In the studies it reviewed, deaths from AAA over 5 to 12 years were rare (under 3%) in men whose first ultrasound was normal, meaning an aorta under 3 cm. It says more research is needed on whether a second scan helps. (USPSTF, 2019)

Do I need a referral for AAA screening with Medicare?

Yes. Medicare.gov says you must get a referral from your health care provider. (Medicare.gov)

Can I get an AAA ultrasound after 75?

The USPSTF recommendations cover ages 65 to 75. Medicare counts smoking as a risk only for men 65 to 75, while its family history condition names no age range. Ask your doctor whether a scan makes sense for you. (USPSTF, 2019) (Medicare.gov)

Source

U.S. Preventive Services Task Force, "Abdominal Aortic Aneurysm: Screening", final recommendation released December 10, 2019. Read it on uspreventiveservicestaskforce.org. Checked against the live page on 2026-10-28.

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