NCHR Comments on Asymptomatic Carotid Artery Stenosis Screening

August 31, 2020.


National Center for Health Research’s Public Comments on the United States Preventive Services Task Force’s Draft Recommendation Statement Regarding Asymptomatic Carotid Artery Stenosis Screening

We are writing to express our views on the U.S. Preventive Services Task Force’s (USPSTF) draft recommendation statement regarding the screening for asymptomatic carotid artery stenosis.

The National Center for Health Research is a nonprofit think tank that conducts, analyzes, and scrutinizes research on a range of health issues, with particular focus on which prevention strategies and treatments are most effective for which patients and consumers. We do not accept funding from companies that make products that are the subject of our work, so we have no conflicts of interest.

We support the USPSTF’s reaffirmation of the “D” grade recommendation first issued in 2014 against screening for asymptomatic carotid artery stenosis in the general adult population. Although there are several risk factors associated with carotid artery stenosis, currently asymptomatic patients who are or are not at an increased risk for carotid artery stenosis cannot be reliably identified. We therefore agree with the USPSTF that the harms of screening for asymptomatic carotid artery stenosis outweigh the benefits with moderate certainty.

We also agree that more research is needed to better assess the benefits and harms of screening, as was noted in the USPSTF recommendation. In particular, it is important to gain a better understanding of which patients are at high risk for carotid artery stenosis and which patients are at risk for stroke due to carotid artery stenosis.

The National Center for Health Research can be reached at info@center4research.org or at (202) 223-4000.