In accordance with the recommendations of the US Preventive Services Task Force and the UK National Screening Committee in favour of screening for abdominal aortic aneurysms (AAAs),1 2 the United Kingdom’s NHS began phased implementation of routine screening for all men at age 65 years. According to the guidelines,3 about five in every 1000 men screened will have an AAA greater than 55 mm and will be referred for surgery to prevent rupture and related death. In addition, another 35 men will have an AAA of 30-54 mm and will be followed with regular ultrasounds, lifestyle counselling, and medical management. The remaining 960 of 1000 men with an aorta less than 30 mm will be discharged from the programme with no further follow-up. However, in the linked study (doi:10.1136/bmj.e2958), Duncan and colleagues present new evidence showing that men with a slightly enlarged aorta (25-29 mm) are also at increased risk of death and hospital admission as a result of chronic disease.4 These …