Fifteen-year follow-up of a randomized clinical trial of ultrasonographic screening for abdominal aortic aneurysms

Authors: Ashton, H. A.; Gao, L.; Kim, L. G.; Druce, P. S.; Thompson, S. G.; Scott, R. A. P.

Source: British Journal of Surgery, Volume 94, Number 6, June 2007 , pp. 696-701(6)

Publisher: John Wiley & Sons, Ltd.

Abstract:

Background:

Long-term benefits of screening for abdominal aortic aneurysm (AAA) are uncertain. These are the final results of a randomized controlled screening trial for AAA in men, updating those reported previously. Benefit and compliance over a median 15-year interval were examined.

Methods:

One group of men were invited for ultrasonographic AAA screening, and another group, who received standard care, acted as controls. A total of 6040 men aged 65-80 years were randomized to one of the two groups. Outcome was monitored in terms of AAA-related events (surgery or death).

Results:

In the group invited for screening, AAA-related mortality was reduced by 11 per cent (from 1·8 to 1·6 per cent, hazard ratio 0·89) over the follow-up interval. Screening detected an AAA in 170 patients; 17 of these died from an AAA-related cause, seven of which might have been preventable. The incidence of AAA rupture after an initially normal scan increased after 10 years of follow-up, but was still low overall (0·56 per 1000 person-years).

Conclusion:

Screening with a single ultrasonography scan still conferred a benefit at 15 years, although the results were not significant for this population size. Fewer than half of the AAA-related deaths in those screened positive could be prevented. Registration number: ISRCTN 00079388 (http://www.controlled-trials.com). Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Document Type: Miscellaneous

DOI: http://dx.doi.org/10.1002/bjs.5780

Publication date: 2007-06-01

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