Population	Adults without a history of transient ischemic attack, stroke, or other neurologic signs or symptoms
Recommendation	Do not screen for asymptomatic carotid artery stenosis in the general adult population.
	Grade: D
Risk assessment	The major risk factors for carotid artery stenosis include older age, male sex, hypertension, smoking, hypercholesterolemia, diabetes mellitus, and heart disease.
Screening tests	All screening strategies, including ultrasonography with or without confirmatory tests (digital subtraction or magnetic resonance angiography), have imperfect sensitivity and specificity and could lead to unnecessary surgery and result in serious harms, including death, stroke, and myocardial infarction. There is no evidence that screening by auscultation of the neck to detect carotid bruits is accurate or provides benefit.
Balance of benefits and harms	The harms of screening for asymptomatic carotid artery stenosis outweigh the benefits.
Other relevant USPSTF recommendations	The USPSTF has made recommendations on many factors related to stroke prevention, including screening for hypertension, screening for dyslipidemia, the use of nontraditional coronary heart disease risk factors, counseling on smoking, and counseling on healthful diet and physical activity. In addition, the USPSTF recommends the use of aspirin for persons at increased risk for cardiovascular disease. These recommendations are available on the USPSTF Web site (http://www.uspreventiveservicestaskforce.org).