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February 02, 2021
The US Preventive Services Task Force (USPSTF) continues to recommend against screening the general adult population for asymptomatic carotid stenosis, maintaining its stance from 2014.
“The USPSTF found no new substantial evidence that could change its recommendation and therefore concludes with moderate certainty that the harms of screening for asymptomatic carotid artery stenosis outweigh the benefits,” according to its statement published in the February 2, 2021, issue of
JAMA.
Task force member Michael Barry, MD (Harvard Medical School, Boston, MA), explained the rationale. Few strokes are attributable to carotid stenosis, and among patients with carotid disease, the annual rate of stroke is only about 1%. Screening tests, usually duplex ultrasound, are fairly accurate, but false-positive results can lead to unnecessary downstream testing and treatment. Moreover, revascularization with carotid endarterectomy or stenting does not appear to have a major