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Screening for abdominal aortic aneurysm.

P A Cosford¹, G C Leng

¹Victoria House, East of England Strategic Health Authority, Capital Park, Fulbourn, Cambridge, UK, CB1 5XB. Paul.Cosford@eoe.nhs.uk

The Cochrane Database of Systematic Reviews

|April 20, 2007

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Ultrasound screening for abdominal aortic aneurysm (AAA) significantly reduces mortality in men aged 65-79. Evidence for benefit in women is insufficient, and cost-effectiveness requires further analysis for population-based programs.

Area of Science:

Vascular Surgery
Public Health
Diagnostic Imaging

Background:

Abdominal aortic aneurysm (AAA) affects 5-10% of men aged 65-79.
Rupture is a life-threatening complication with high mortality.
Current guidelines recommend elective repair for aneurysms >5.5 cm.

Purpose of the Study:

To evaluate the impact of screening asymptomatic individuals for AAA.
To assess effects on mortality, treatment, quality of life, and cost-effectiveness.
To inform decisions regarding population-based screening programs.

Main Methods:

Systematic review of randomized controlled trials (RCTs).
Searched Cochrane Peripheral Vascular Diseases Group Trials Register and CENTRAL.
Data extracted by two independent reviewers.

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Main Results:

Four RCTs involving over 137,000 participants (mostly men).
Significant reduction in AAA mortality for screened men (OR 0.60).
Decreased incidence of ruptured AAA in men (OR 0.45), increased surgery rates (OR 2.03).

Conclusions:

Ultrasound screening significantly reduces AAA mortality in men aged 65-79.
Insufficient evidence of benefit for women.
Cost-effectiveness warrants further investigation before implementing widespread screening.