AAA Screening in Primary Care: Criteria, Implementation, and Patient Communication

Abdominal aortic aneurysm (AAA) screening is one of the highest-yield preventive interventions we can offer in primary care—yet implementation remains inconsistent. The test is simple, covered by insurance, and can identify a potentially lethal condition before it becomes catastrophic. So why aren't all eligible patients being screened?

The answer often comes down to workflow integration and patient communication, emergency medicine physician Kabiul Haque, MD, told Patient Care in a recent interview. Clinicians may not consistently identify eligible patients, and when screening is offered, patients may hesitate due to concerns about cost, invasiveness, or what happens if something is found.

Patient Care® spoke with Dr Haque, during the 2025 FMX conference in Anaheim. In the video above, Dr Haque, a clinical assistant professor of family medicine at Ochsner LSU Health System in Shreveport, LA, breaks down the current USPSTF screening criteria and shares practical strategies for integrating AAA screening into routine practice while addressing the most common patient objections.

In this segment, Dr Haque covers:

• Current USPSTF screening guidelines for AAA
• How to identify eligible patients systematically
• Addressing patient concerns about cost and insurance coverage
• Communicating the value and simplicity of ultrasound screening
• What to tell patients about next steps if AAA is detected

The following transcript has been lightly edited for style and clarity.

Patient Care: Can you walk us through the current screening criteria for AAA and how PCPs can integrate this into routine practice?

Kabiul Haque, MD: So the current USPSTF criteria for AAA—men who have ever smoked cigarettes, age between 65 to 75, they should be screened at least one time in their life by ultrasound for AAA. So that's the USPSTF guideline. So all primary care physicians should ask the patient if it's a male. We have to ask, have you ever smoked cigarettes? Now, if the man has ever smoked cigarettes and is between 65 to 75, they should, by default, offer the patient, "Hey, have you ever done an AAA screening test?" If the patient says no, then they should integrate. They should convince the patient, yes, you need to get the AAA screening test. Now, sometimes it is difficult to convince the patient. So the patient might think that, hey, I'm going to get an ultrasound. Is it going to cost me money, right? And if I get diagnosed, then what will happen? So sometimes patients can get confused or they might be scared, but as a doctor, as a physician or primary care doctor, it's our job to tell the patient, yes, it is needed, and usually the insurance covers it because it's a preventative test. You are 65 to 75, you smoked cigarettes, and you're a man. Insurance will cover you for at least one time ultrasound to rule in or rule out AAA. And then if it comes back, you know, positive, if you have AAA, then we can definitely help you to get to the vascular surgeon. Or if your diameter size is not too big, then we can also medically manage that or optimize the care to help you live longer.