Lower prevalence than expected when screening 70-year-old men for abdominal aortic aneurysm

Area of Science:

• Vascular Surgery
• Public Health Screening
• Geriatric Medicine

Background:

• Screening 65-year-old men for abdominal aortic aneurysms (AAA) is cost-effective but shows lower prevalence than anticipated.
• The benefit of current screening strategies is questioned due to lower-than-expected AAA prevalence.
• AAA prevalence increases with age, suggesting older age groups may benefit more from screening.

Purpose of the Study:

• To determine the contemporary screening-detected prevalence of abdominal aortic aneurysms (AAA) among 70-year-old men.
• To assess the impact of age on AAA screening effectiveness.
• To identify risk factors associated with AAA in this demographic.

Main Methods:

• A population of 5,623 unscreened 70-year-old men was invited for ultrasound screening.
• Univariable and multivariable analyses were performed to identify AAA risk factors.
• Attendance rates and prevalence of previously unknown AAAs were recorded.

Main Results:

• The attendance rate for the screening program was 84.0%.
• The prevalence of previously unknown abdominal aortic aneurysms (AAA) was 2.3%.
• The total AAA prevalence was at least 3.0%, with 37.4% of cases already known; smoking was the primary risk factor.

Conclusions:

• Screening 70-year-old men for AAA revealed a prevalence less than half of expectations, despite high attendance.
• Smoking (past and current) emerged as the most significant risk factor for AAA.
• A substantial proportion (nearly 40%) of identified AAAs were already diagnosed through other means, not screening.