ORIGINAL ARTICLES   

International Angiology 2014 October;33(5):474-9

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

No benefit of screening for abdominal aortic aneurysm among 70- instead of 65-year-old men

Hager J. ¹, Länne T. ¹, Carlsson P. ², Lundgren F. ¹ ✉

¹ Department of Medical and Health Sciences, Linköping University, Department of Cardiovascular Surgery, County Council of Östergötland, Linköping, Sweden; ² Centre for Medical Technology Assessment, Division of Health Care Analysis; ³ Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

AIM: Screening 65-year-old men for abdominal aortic aneurysm (AAA) reduces mortality from ruptured AAA (rAAA). Lower than expected prevalence of AAA is now found, why screening at a higher age and rescreening has been discussed. Our aim was to determine if screening at 70 years of age, instead of 65, increases clinical effectiveness.
METHODS: Seven thousand nine hundred fifty-one and 5623 previously un-screened 65- and 70-year old men were invited to ultrasound screening.
RESULTS: The attendance rate was 85.7% and 84.0%, P<0.01, for the 65- and 70-year old men respectively. The screening-detected prevalence did not differ, being 1.9% and 2.3%, P=0.15, respectively, probably due to the fact that 23.5% and 37.4% of all known AAA among 65- and 70-year-old men, were detected by other means prior to screening, P<0.01. However, the total known prevalence differed between the age-groups, being at least 2.1% and 3.0% respectively, P<0.001.
CONCLUSION: The screening-detected AAA-prevalence did not differ between 65- and 70-year-old men, due to the greater number of AAA known prior to screening among 70- compared to 65-year-old men. Screening men at 70 instead of 65 years of age would not result in detection of substantially more previously unknown AAA, thus not preventing rAAA and consequently not more saved life-years. Further, data also indicates that it is questionable if re-screening the 65-year-old male population after five years would generate any important clinical effect.