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INTRODUCTION Abdominal aortic aneurysm (AAA) is a silent pathology with often fatal consequences in case of rupture. AAA screening, recommended in France and many other countries, has shown its effectiveness in reducing specific mortality. However, AAA screening rate remains insufficient. OBJECTIVE To identify barriers to AAA screening in general practice. MATERIAL AND METHOD Qualitative study carried out during 2016 among general practitioners based in Paris. RESULTS Fourteen physicians were included. Most of the barriers were related to the physician: unawareness about AAA and screening recommendations, considering AAA as a secondary question not discussed with the patient, abdominal aorta not included in cardiovascular assessment, no search for a familial history of AAA, AAA considered a question for the specialist, lack of time, lack of training, numerous screenings to propose, oversight. Some barriers are related to the patient: unawareness of the pathology and family history of AAA, refusal, questioning the pertinence of the doctor's comments, failure to respect the care pathway. Others are related to AAA: source of anxiety, low prevalence, rarity of complications. The remaining barriers are related to screening: cost-benefit and risk-benefit ratios, sonographer unavailability, constraint for the patient, overmedicalization. CONCLUSION Information and training of general practitioners about AAA must be strengthened in order to optimize AAA screening and reduce specific mortality.

Introduction L’anevrisme de l’aorte abdominale (AAA) est une pathologie silencieuse aux consequences souvent fatales en cas de rupture. Son depistage, recommande en France et dans d’autres pays, a montre son efficacite sur la reduction de la mortalite specifique. Ce taux de depistage reste cependant insuffisant. Objectif Identifier les freins au depistage de l’AAA en medecine generale. Materiel et methode Etude qualitative par entretiens individuels semi-directifs menee courant 2016 aupres de medecins generalistes exercant a Paris. Resultats Quatorze medecins ont ete inclus. La plupart des freins sont lies au medecin : meconnaissance de la pathologie et des recommandations, pathologie consideree comme annexe et non abordee avec le patient, bilan cardiovasculaire ne s’interessant pas a l’aorte abdominale, antecedents familiaux d’AAA non recherches, delegation au medecin specialiste, manque de temps, absence de formation, nombreux depistages a proposer, omission. Certains freins sont lies au patient : meconnaissance de la pathologie et des antecedents familiaux d’AAA, refus, remise en cause des propos du medecin, non-respect du parcours de soin. D’autres sont lies a l’AAA : source d’anxiete, faible prevalence, rarete des complications. Les freins restants sont lies au depistage : rapports cout-benefice et benefice-risque, indisponibilite de l’echographiste, contrainte pour le patient, surmedicalisation. Conclusion La formation des medecins generalistes et l’information du grand public, a l’origine de la plupart des freins au depistage de l’AAA, doivent etre renforcees afin d’optimiser l’effectivite du depistage et de reduire la mortalite liee a cette pathologie.