Screen Does Not Cut Abdominal Aortic Aneurysm Mortality in Men
FRIDAY, June 15, 2018 -- Screening men for abdominal aortic aneurysm (AAA) does not reduce AAA-related mortality, according to a study published in the June 16 issue of The Lancet.
Minna Johansson, M.D., from the University of Gothenburg in Sweden, and colleagues compared data on the incidence of AAA, AAA mortality, and surgery for AAA in a cohort of men aged 65 years who were invited to screening between 2006 and 2009, as well as an age-matched contemporaneous cohort of men not invited for screening.
The researchers found that between the early 2000s and 2015 there was a decrease in AAA mortality in Swedish men, from 36 to 10 deaths per 100,000 men aged 65 to 74 years. In all Swedish counties, mortality decreased at similar rates, regardless of whether AAA screening was offered. A non-significant reduction in AAA mortality that was associated with screening was seen after six years with screening (adjusted odds ratio, 0.76; 95 percent confidence interval, 0.38 to 1.51); for every 10,000 men offered screening, two men would avoid death. Screening correlated with significantly increased odds of AAA diagnosis and risk of elective surgery; for every 10,000 men offered screening, 49 are likely to be over-diagnosed, 19 of whom will likely have avoidable surgery.
"AAA screening in Sweden did not contribute substantially to the large observed reductions in AAA mortality," the authors write. "The small benefit and substantially less favorable benefit-to-harm balance call the continued justification of the intervention into question."
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Posted: June 2018