Editorial

Screening for abdominal aortic aneurysm

BMJ 2007; 335 doi: 10.1136/bmj.39307.634560.AD (Published 11 October 2007)
Cite this as: BMJ 2007;335:732

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  1. Roger Greenhalgh, emeritus professor of surgery,
  2. Janet Powell, professor of vascular biology
  1. Vascular Surgical Research Group, Imperial College, London W6 8RP
  1. Correspondence to: R Greenhalgh rmg.pa{at}ic.ac.uk

    Can save lives but only if operative mortality is low

    A recent Cochrane review has updated our knowledge about screening asymptomatic people for abdominal aortic aneurysm, with respect to their mortality, subsequent treatment for the aneurysm, and the cost effectiveness of screening.1 Four completed randomised controlled studies—Chichester, Viborg, Western Australia, and the multicentre aneurysm screening study (MASS)—with 127 891 men and 9342 women (only the Chichester trial included women) aged from 65-83

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

    In men aged 65-79 years screening significantly reduced the risk of mortality related to aneurysm (relative risk 0.53 (confidence interval 0.42 to 0.68). This was achieved at the expense of doubling the rate of aneurysm surgery. However, for studies in men, the review reported no significant reduction in all cause mortality. …

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