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Screening Older Adult Men for Abdominal Aortic Aneurysm: A Scoping Review
Priya Bains1, John L Oliffe1,2, Martha H Mackay1,3
1School of Nursing, University of British Columbia, Vancouver, BC, Canada.
Insights
Screening older men for abdominal aortic aneurysm (AAA) shows benefits like reduced rupture and mortality, but also potential harms such as quality of life impacts. Guidelines may need updates based on current evidence.
Area of Science:
- Vascular Surgery
- Preventative Medicine
- Public Health Policy
Background:
- Abdominal aortic aneurysm (AAA) is a significant cause of mortality, primarily affecting older men.
- Current guidelines recommend ultrasound screening for AAA in men aged 60 and over.
- Screening aims for early detection to reduce AAA-related deaths.
Purpose of the Study:
- To conduct a scoping review of empirical studies on AAA screening in men.
- To identify and analyze the benefits and potential harms of male AAA screening.
- To inform potential changes in AAA screening guidelines, policy, and practice.
Main Methods:
- A scoping review methodology was employed.
- Included 19 empirical studies focusing on AAA screening in men.
- Synthesized findings on benefits, harms, and practical implementation.
Main Results:
- Benefits include decreased AAA rupture and mortality, improved surgical repair outcomes, and cost-effectiveness.
- Potential harms involve no significant reduction in AAA mortality, negative quality of life impacts, and inconsistent application of screening criteria.
- Evidence highlights both advantages and disadvantages of current screening practices.
Conclusions:
- AAA screening in men offers significant benefits but also presents potential harms that require careful consideration.
- Findings suggest a need for re-evaluation and potential modification of existing AAA screening guidelines.
- Improvements in policy and practice are recommended to optimize screening effectiveness and patient well-being.
Abstract:
Abdominal aortic aneurysm (AAA) is a potentially fatal condition predominantly affecting older adult men (60 years or over). Based on evidence, preventative health-care guidelines recommend screening older males for AAA using ultrasound. In attempts to reduce AAA mortality among men, screening has been utilized for early detection in some Western countries including the UK and Sweden. The current scoping review includes 19 empirical studies focusing on AAA screening in men. The findings from these studies highlight benefits and potential harms of male AAA screening. The benefits of AAA screening for men include decreased incidence of AAA rupture, decreased AAA mortality, increased effectiveness of elective AAA repair surgery, and cost-effectiveness. The potential harms of AAA screening included lack of AAA mortality reduction, negative impacts on quality of life, and inconsistent screening eligibility criteria being applied by primary care practitioners. The current scoping review findings are discussed to suggest changes to AAA screening guidelines and improve policy and practice.
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