Screening reduces all cause mortality in men

doi:10.1136/bmj.39381.375972.BE

BMJ 2007;335:899 (3 November), doi:10.1136/bmj.39381.375972.BE

Letters

Abdominal aortic aneurysm

Screening reduces all cause mortality in men

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

Greenhalgh and Powell¹ cite a recent Cochrane review, whichreported that screening asymptomatic people for abdominal aorticaneurysm (AAA) significantly reduced not all cause but AAA relatedmortality in men aged 65-79. The review, however, excluded somerecent studies with long follow-up.² ³ ⁴ Therefore, we performeda meta-analysis of randomised controlled studies with long follow-upof screening for AAA in men (both AAA related and all causemortality).⁵

Our comprehensive search identified four reports—the Chichesterstudy (over 15 year follow-up),² the Viborg country study (median9.6 year follow-up),³ the Western Australia study (median 3.6year follow-up), and the multicentre aneurysm screening study(mean 7.1 year follow-up).⁴ Pooled analysis of the four reportsshowed a statistically significant reduction in AAA relatedmortality (risk difference –0.25%, 95% confidence interval–0.46% to –0.04%) and all cause mortality (–1.06%,–1.81% to –0.31%) with screening relative to controlin a random effects model.⁵