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AAA Screening Can Decrease Deaths in Men Who Have Smoked

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AAA Screening Can Decrease Deaths in Men

AAA Screening Can Decrease Deaths in Men Who Have Smoked

April 13, 2005

By: Jean Johnson for Veins1

A one-time screening may decrease the number of men who die from abdominal aortic aneurysms (AAA). Major risk factors for AAA include: Male sex, a history of ever smoking (as defined by 100 cigarettes during a person’s lifetime), and age 65 years or older. Factors associated with decreased risk include female sex, diabetes mellitus, and black race. A family history of AAA also elevates a man’s risk for AAA.

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Tips for Quitting Smoking

1. Come to terms with the idea that even smoking is an emotional response to life’s stress.

2. Make a list of realistic things to do instead of turning to cigarettes.

3. Expect persistent cravings and set up a plan for riding out these intense waves.

4. Know that urges to smoke will not last forever and while intense, they do have a beginning and ending.

5. Getting out of the house and walking off the urge can work when nothing else seems to.

6. Take time for extra self care during the early vulnerable stages of cessation.

7. Consider what to buy with the extra money saved.

8. Breathe deep in the early morning dawn. Listen to the birds and let the pink and gold dawn renew your commitment to health and life.

On the plus side, the prestigious U.S. Preventive Services Task Force – a group of medical experts that advises the federal Agency for Healthcare Research and Quality, the group that sets policies primary care physicians tend to adhere to – has come out in favor of a one -time screening for AAA that is anticipated to decrease the current number of 9,000 men who die annually. Said Dr. Craig Fleming, of the Kaiser Permanente Center for Health Research in Portland where the review was completed, “It’s a very preventable cause of death … It’s not often that we have such a positive finding for a screening test.”

The aneurysm occurs in the lower part of the aorta in the back of abdomen near the spine where the heart’s major artery funnels blood supply to the extremities. What begins as a small weakening in the wall of the artery, leads to a slow ballooning out over a period of years. Once the aneurysm enlarges to approximately 2 inches, the thinned and distended part of the aortic wall can burst without warning and bring almost immediate death. Today’s researchers assume that many cases of AAA-related mortality in the past have been attributed to heart attack or stroke rather than the actual aneurysm.

There are no symptoms associated with AAA and the condition is not detectable any way other than via ultrasonography. Task force physicians are recommending a one time screening at age 65 via a 10-minute painless ultrasound scan. The procedure is estimated at $350-$400. If an aneurysm close to 2 inches is found, surgeons can repair the site in an operation that runs from $15,000 to $20,000 at 2005 prices.

Dr. Ned Calonge, chairman of the task force, said that “the science comes down to saying this is worth doing.” Still the report published by the task force in the Annals of Internal Medicine noted that “there is a short-term impact of AAA screening on quality-of-life measures. Those testing positive for AAA initially had more anxiety and lower physical and mental health scores that those testing negative.”

Indeed, in cases where scans show small aneurysms and patients have to wait for the site to grow large enough for surgery, knowing one’s number could be up at any moment is an unnerving proposition.

David McKee, a 61-year-old from Northern Arizona who has smoked since his twenties, said, “I’d just as soon not know. At least it sounds like it takes you fast. I’ve always thought going while I walked out of the Grand Canyon would be better than some long drawn out thing anyway.”

Editor’s note: As it turned out, before this article was published, Mr. McKee had a stroke and was forced to abruptly quit smoking. From his hospital bed he remarked, “If I’d known it was this easy, I would have quit a long time ago.”

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