Screening men halves aortic aneurysm deaths

Regular screening for abdominal aortic aneurysms can slash the likelihood of dying from a ruptured aneurysm among men by half, UK research suggests.

At present, the mortality rate after rupture is high. Half of all patients undergoing surgery for emergency aneurysm repair will die from their ruptures.

Elective surgery is recommended for aneurysms larger than 5.5cm to prevent rupture.

But the researchers found that ultrasound screening could be used to cut the number by half in men aged 65–79.

For the study, four controlled trials were set up involving 127,891 men and 9,342 women, aged 65 to 79 years, who were randomly assigned to aortic aneurysm screening using ultrasound or no screening.

Ultrasound screening did not, however, reduce the risk of rupture among women.

Men who received screening were found to be twice as likely to undergo surgery for a rupture than women.

But study co-author Dr Paul Cosford, of the East of England SHA, warned that screening for aortic aneurysms was controversial, he said: ‘The balance between risk of rupture and risk of elective surgical repair is difficult to judge for people who are healthy.

‘Patients may therefore be asked to undergo this risk to repair a large aneurysm which may not kill them.’

West London GP Dr Sarah Jarvis, a member of the Primary Care Cardiovascular Society (PCCS), said: ‘Screening for aneurysms is an issue which keeps coming up, largely because the mortality rate from ruptured aortic aneurysms is so much higher than that following elective repair.’

We need to know what population groups to target and whether the treatment is beneficial enough for it to be worth screening at a population level, said Dr Jarvis.

‘I suspect that the cost per life saved by screening is likely to be very high.’

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