Is screening of abdominal aortic aneurysm effective in a general practice setting?

Area of Science:

• Vascular Surgery
• Preventive Medicine
• Diagnostic Imaging

Background:

• Abdominal aortic aneurysms (AAAs) pose a significant health risk, particularly in older male populations.
• Early detection and intervention are crucial for managing AAA and preventing rupture.
• Screening programs aim to identify AAAs before they become life-threatening.

Purpose of the Study:

• To evaluate the feasibility and patient acceptability of ultrasound screening for AAAs.
• To assess the impact of ultrasound screening on the rupture rate of abdominal aortic aneurysms.
• To identify prevalent risk factors associated with AAAs in the screened population.

Main Methods:

• A prospective, population-based study involving 2709 men aged over 60 years across 11 general practices.
• Ultrasound screening for AAAs was offered between January 1996 and December 2003.
• Analysis included patient acceptance rates, AAA detection rates, associated risk factors, and annual rupture rates.

Main Results:

• A high acceptance rate of 95% (2561/2709) was observed for the ultrasound screening.
• 81 patients (3.4%) were diagnosed with an AAA, with 22 identified as large (>5 cm).
• Key risk factors included smoking (84%) and hypertension (40%). The annual AAA rupture rate decreased from 47% to 14% during the study period.

Conclusions:

• Ultrasound screening for abdominal aortic aneurysms is a feasible and acceptable intervention in primary care for elderly men.
• Implementing AAA screening programs can lead to a significant reduction in the incidence of ruptured abdominal aortic aneurysms.
• Risk factor identification, such as smoking and hypertension, is important in the context of AAA screening.