Population screening reduces the total community mortality rate from aortic aneurysms

Background: Screening of the male population for unsuspected abdominal aortic aneurysm (AAA) has been taking place in a single UK county (population 520 000) since 1990. Methods: The general practitioner surgery‐based programme involves ultrasonographic examination of each year's new batch of 65‐year‐old men, excluding those who were older than this when the programme started. This method of screening has resulted in a gradually enlarging cohort of screened men, so that by the end of 1998 all men between the ages of 65 and 73 years had been offered an ultrasound scan, with 85 per cent accepting and over 21 000 men examined. Total aneurysm‐related deaths in the community have been quantified by examining inpatient records and post‐mortem results for the county's hospitals, together with computerized death certificate records held by the health authority (available for 1994 onwards). This figure thus includes deaths at home from ruptured AAA, in‐hospital deaths from ruptured AAA with or without emergency surgery and all deaths following elective AAA surgery. Results: The 65–73‐year‐old age group has been progressively influenced by AAA screening as new 65 year olds are examined each year. Total aneurysm‐related deaths in this age range have shown a progressive, year by year fall between 1994 and 1998, with an overall reduction in deaths by two‐thirds during this 5‐year period. In contrast, aneurysm‐related deaths in men aged below 65 and over 73 years have tended to show a slight increase in the same period. Conclusion: These figures clearly demonstrate that population screening reduces overall deaths from aortic aneurysms. © 2000 British Journal of Surgery Society Ltd