Publication
Comparison of three targeted approaches to screening for abdominal aortic aneurysm based on cardiovascular risk
Publisher:
Oxford University Press (OUP)
Date:
18-07-2016
DOI:
10.1002/BJS.10224
Abstract: Abdominal aortic aneurysm (AAA) continues to be a significant health burden yet few countries have implemented a comprehensive screening programme. Screening typically places emphasis on men aged over 65 years however, there is concern that other at-risk groups may be underidentified. The present study examined three potential screening strategies based on cardiovascular risk. The prevalence of AAA was determined by abdominal ultrasound imaging in over 50-year-olds of either sex undergoing coronary angiography, vascular laboratory assessment of peripheral arterial disease, or community-based cardiovascular disease (CVD) event risk assessment. A fourth group, consisting of volunteers aged over 60 years who had no symptoms or signs of cardiovascular disease, was used as a comparator group. A total AAA prevalence of 4·4 per cent was detected across all three strategies (137 of 3142 in iduals), compared with 1·0 per cent in the CVD-free group. Male sex, age and smoking were all associated with greater AAA prevalence. Although AAA prevalence was lowest using the community-based strategy, those with an AAA detected were on average 7 years younger than those with AAAs detected with the other two strategies (P & 0·001). Different strategies, based on CVD risk, resulted in AAA prevalence rates that were significantly greater than that in CVD-free in iduals. This may provide opportunities for a targeted approach to community AAA screening in parts of the world where more sophisticated national screening programmes do not exist.