A comparison between the short term and long term benefits of screening for abdominal aortic aneurysms from the Huntingdon Aneurysm screening programme

Eur J Vasc Endovasc Surg. 2006 Jul;32(1):16-20. doi: 10.1016/j.ejvs.2005.12.016. Epub 2006 Feb 7.

Abstract

Background: The UK Multicentre Aneurysm Screening Study (MASS) showed a 44% reduction in AAA-related mortality after 4 years and predicted an increased number of deaths prevented in the longer term. We aim to compare the 5 and 13 years benefit from aneurysm screening in the Huntingdon Aneurysm screening programme.

Methods: Incidence and mortality of ruptured AAA (RAAA) after 5 and 13 years of screening in a population based aneurysm screening program.

Results: Five years of screening resulted in a reduction in the incidence of RAAA of 49% (95% CI: 3-74%). Nine out of 11 ruptures in the invited group did not survive (mortality 82%; 95% CI: 48-98%) compared to 38 non-survivors from 51 ruptures in the control group (mortality 75%; 95% CI: 60-86%). Five years of screening resulted in an RAAA-related mortality reduction of 45% (95% CI: -15 to 74%). After 13 years of screening the incidence of RAAA was reduced by 73% (95% CI: 58-82%). Twenty-one out of 29 ruptures in the invited group did not survive (mortality 72%; 95% CI: 53-87%) compared to 64 non-survivors from 82 ruptures in the control group (mortality 78%; 95% CI: 68-86%). Thirteen years screening resulted in a reduction of mortality from RAAA of 75% (95% CI: 58-84%). The number needed to screen to prevent one death reduced from 1380 after 5 years to 505 after 13 years. The number of elective AAA operations needed to prevent one death reduced from 6 after 5 years to 4 after 13 years.

Conclusion: AAA screening becomes increasingly beneficial as screening continues over the longer term. Benefits continue to increase after screening has ceased.

Publication types

  • Comparative Study

MeSH terms

  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / epidemiology*
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Rupture / epidemiology*
  • Aortic Rupture / mortality
  • Aortic Rupture / prevention & control
  • Clinical Trials as Topic
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Mass Screening*
  • Middle Aged
  • Survival Analysis
  • Time Factors
  • United Kingdom / epidemiology