Fishing for BASS: Surveying primary physicians in the Barriers to Aortic Screening Study. 

EM Wooster BComm, DL Wooster MD, A Dueck MD
University Health Network, Toronto General Hospital, University of Toronto, Toronto, ON

Primary care physicians were surveyed to determine attitudes and identify barriers to screening for AAAs.

600 standardized, structured surveys were distributed to all primary care practitioners in a defined geographic area.  Participation was voluntary, and results were anonymous. 

74.4% of respondents were general practitioners; 92.5% worked in a community setting.
55.8% saw >11 male patients per week who were over age 65.  Responses indicated support for identifying asymptomatic AAAs; only 4.7% thought their patients were too sick to undergo repair, 0% felt their patients would be unwilling to undergo repair, and 0% felt the risk of rupture was too small to justify repair.  Access to vascular surgical services was available to 76.7% in the hospital closest to them, and to 100% in the city in which they practice. 

60.4% were aware of the recommendations.  20.9% of physicians routinely screened eligible patients for AAAs.  Respondents routinely screened patients for breast cancer (79.1%), prostate cancer (80.5%), colon cancer (80.9%), and hypertension (83.7%).  42.9% routinely screened for peripheral artery disease.

Although primary practitioners are routinely exposed to the target population, the minority of patients are screened.  Neither access to a vascular surgeon nor knowledge about the importance of AAAs appear to be limiting factors.  Despite recent publicity, almost 40% of primary care physicians remain unaware of screening guidelines for AAAs.  Of those who were aware of guidelines, only one third follow them.  Screening for AAAs lags significantly behind other major screening programs.