Screening for abdominal aortic aneurysm

doi:10.1136/bmj.39307.634560.AD

BMJ 2007;335:732-733 (13 October), doi:10.1136/bmj.39307.634560.AD

Editorials

Screening for abdominal aortic aneurysm

Can save lives but only if operative mortality is low

The first 150 words of the full text of this article appear below.

A recent Cochrane review has updated our knowledge about screeningasymptomatic people for abdominal aortic aneurysm, with respectto their mortality, subsequent treatment for the aneurysm, andthe cost effectiveness of screening.¹ Four completed randomisedcontrolled studies—Chichester, Viborg, Western Australia,and the multicentre aneurysm screening study (MASS)—with127 891 men and 9342 women (only the Chichester trial includedwomen) aged from 65-83

years were included to a cut-off date of 26 January 2007. Thisexcluded the more recent seven year follow-up of men in MASS.²Acceptance rates (of people agreeing to be screened) rangedfrom 63.1% (Western Australia) to 80.2% (MASS).

In men aged 65-79 years screening significantly reduced therisk of mortality related to aneurysm (relative risk 0.53 (confidenceinterval 0.42 to 0.68). This was achieved at the expense ofdoubling the rate of aneurysm surgery. However, for studiesin men, the review reported no significant reduction in all. . . [Full text of this article]

Roger Greenhalgh, emeritus professor of surgery, Janet Powell, professor of vascular biology

Vascular Surgical Research Group, Imperial College, London W6 8RP

Correspondence to: R Greenhalgh rmg.pa@ic.ac.uk

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