Family screening for abdominal aortic aneurysms: a systematic review and meta-analysis

Area of Science:

• Vascular Surgery
• Genetics
• Public Health Screening

Background:

• International guidelines advocate for screening first-degree relatives of abdominal aortic aneurysm (AAA) patients.
• The precise prevalence of AAA in this screened relative population remains uncertain.

Purpose of the Study:

• To determine the prevalence of abdominal aortic aneurysm (AAA) among first-degree relatives of patients diagnosed with AAA.
• To assess the prevalence of familial AAA and compare AAA risk between male and female relatives.

Main Methods:

• A systematic literature search was conducted across Medline, Embase, and Cochrane Library up to March 2026.
• Meta-analysis of data from 26 studies involving 4166 index patients and 4530 relatives was performed using a random-effects model.
• Risk of bias and evidence quality were assessed using validated tools and GRADE criteria.

Main Results:

• The overall prevalence of AAA in relatives was 14.4%, with 21.9% in males and 6.3% in females.
• Familial AAA prevalence was 16.9%, and male relatives had approximately four times the odds of having AAA compared to female relatives.
• Screened female relatives showed a 5-fold increased risk, and male relatives a 3-fold increased risk of AAA compared to controls.

Conclusions:

• First-degree relatives of AAA patients represent a highly enriched population for AAA.
• The findings strongly support screening all first-degree relatives, both male and female, irrespective of the index patient's family history.
• These results underscore the importance of family-based screening for abdominal aortic aneurysm.