Screening men for aortic aneurysm

A national population screening service will be cost effective

Papers p 1135

Abdominal aortic aneurysm is a potentially lethal condition, much more common in older men, and, sadly, often first recognised only after rupture and death. Some 75% of patients die before arriving at hospital, and of the survivors, half make it to the operating theatre.1 The operative mortality for ruptured aneurysm remains about 40% at 30 days,2 compared with a mortality of 5-6% for elective surgery.3 Surely early ultrasound detection should be worth while. We now have the previously missing data to justify a national screening programme.

The Multicentre Aneurysm Screening Study Group reports the outcomes of aneurysm related mortality with health related quality of life and cost effectiveness. 4 5 The authors conclude that a single ultrasound scan in men aged 65 reduces aneurysm related deaths at acceptable cost. They put screening to the test in a population based randomised controlled trial of 70 000 men at four centres in the south of England, an area of relative social privilege. Randomisation was from general practitioners' lists—men in the …