National screening programme for aortic aneurysm

Could make death from rupture a rarity

In 1992 in England and Wales 4515 deaths in men and 1770 in women were certified as being from ruptured abdominal aortic aneurysm, with only 75% of patients with ruptured aneurysms arriving alive at the hospital.1 2 The multicentre aneurysm screening study, a randomised controlled trial, showed a 42% reduction of deaths from abdominal aortic aneurysm by population screening, and, at four years, the cost per quality adjusted life year gained was £28 000, which is expected to fall to £8000 at 10 years.3 4 It has emerged that the 30 day postoperative mortality from elective aneurysm repair is 3% in screened patients from the population compared with 9% in non-screened patients.5 The concept of a national screening programme for aortic aneurysm needed to be tested, and the multicentre aneurysm screening study was an important contribution that has been favourably received.6

What does the National Screening Committee think of this? Its programme director, Dr Muir Gray, says, “the cost benefit analysis in the trial is …