Primary care screening for abdominal aortic aneurysm

Fleming C, Whitlock E, Beil T, Lederle F
Record ID 32005000076
Authors' objectives:

While the prognosis for abdominal aortic aneurysm (AAA) rupture is poor, ultrasound imaging is an accurate and reliable test for detecting AAAs before rupture. This study aims to examine the benefits and harms of population-based AAA screening.

Authors' results and conclusions: We identified four population-based randomized controlled trials of AAA screening in men 65 years and older. Based on meta-analysis, an invitation to attend screening was associated with a significant reduction in AAA-related mortality (OR 0.57; 95% CI, 0.45 to 0.74). A meta-analysis of three trials revealed no significant difference in all-cause mortality (OR 0.98; 95% CI, 0.95 to 1.02). No significant reduction in AAA-related mortality was found in one study of AAA screening in women. Screening does not appear to be associated with significant physical or psychological harms. For 4.0-5.4 cm AAAs, immediate surgical repair, compared to surveillance with delayed repair, does not appear to improve either AAA-related mortality or all-cause mortality. Major treatment harms include 2 to 6% operative mortality rate and significant risk of major complications.
Authors' recommendations: For men age 65 years and older, an invitation to attend AAA screening reduces AAA-related mortality.
Authors' methods: Systematic review
Project Status: Completed
Year Published: 2005
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Mass Screening
  • Aortic Aneurysm, Abdominal
Organisation Name: Agency for Healthcare Research and Quality
Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
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Copyright: Agency for Healthcare Research and Quality (AHRQ)
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