Screening for abdominal aortic aneurysm

Clinical question: 
How effective is ultrasound screening for abdominal aortic aneurysm (AAA)?
Bottom line: 
Ultrasound screening, followed by appropriate management, significantly reduced deaths from AAA in men aged 65 to 79 years (NNS *322 to 1312). There was insufficient evidence to demonstrate benefit in women. The costeffectiveness of a coordinated population-based screening programme may be acceptable but this needs further expert analysis. *NNS = number needed to screen to prevent a death from AAA
Caveat: 
The incidence of AAA in women is lower than for men. All-case mortality was not significantly different betweenscreened and unscreened groups three to five years after screening, which is to be expected given the relative infrequency of AAA as a cause of death. The “high NNS” is similar to other screening procedures.
Context: 
AAA is found in 5-10% of men aged 65 to 79 years. The major complication is rupture, which has a mortality of 80% for patients reaching hospital, and 50% for those undergoing surgery for emergency repair. Currently elective surgical repair is recommended for aneurysms discovered to be larger than 5.5 cm to prevent rupture.
Review CD#: 
CD002945
PEARLS No: 
26
Date: 
October, 2007
Authored by: 
Brian R McAvoy