Some of the reasons for lukewarm support are purely political

Johnson argues that a death rate of one in 14 from elective abdominal aortic aneurysm repair means that screening is futile.1 Many specialist vascular units have elective mortality rates of 5% or less for open repair and mortality rates of less than 2% for endovascular repair (as confirmed by the EVAR trial and Dr Foster). Even a one in 14 death rate is better than 80% mortality from rupture. I and many of my colleagues (including nursing staff) are weary of counselling the grieving wives and children of men who suffer unexpected, agonising, and bloody deaths.

Detection of an abdominal aortic aneurysm provides one important benefit that Johnson ignores—patient choice. Patients who die of rupture are denied that choice. Johnson suggests that screening leads to unacceptable levels of anxiety for those placed on surveillance programmes. This claim is not supported by the literature. Screening for abdominal aortic aneurysm also compares favourably, in cost effectiveness terms, with breast and cervical screening.

I suspect that the government has not funded abdominal aortic aneurysm screening (and even now provides only lukewarm support) because few votes will be won (and more pensions will need to be paid) by saving the lives of men of retirement age. As a politician, Johnson should understand this all too well.