Screening for abdominal aortic aneurysm: lessons from a population-based study.
OBJECTIVE
To test the acceptability of screening and to identify modifiable risk factors for abdominal aortic aneurysm (AAA) in men.


METHODS
A trial of ultrasound screening for AAA in a population-based random sample of men aged 65-83 years, and a cross-sectional case-control comparison of men in the same sample.


METHODS
12,203 men who had an ultrasound examination of their abdominal aorta, and completed a questionnaire covering demographic, behavioural and medical factors.


METHODS
Prevalence of AAA, and independent associations of AAA with demographic, medical and lifestyle factors.


RESULTS
Invitations to screening produced a corrected response of 70.5%. The prevalence of AAAs (> 30 mm) rose from 4.8% in men aged 65-69 years to 10.8% in those aged 80-83 years. The overall prevalence of large (> 50 mm) aneurysms was 0.69%. In a multivariate logistic model Mediterranean-born men had a 40% lower risk of AAA (> 30 mm) compared with men born in Australia (odds ratio [OR], 0.6; 95% CI, 0.4-0.8), while ex-smokers had a significantly increased risk of AAA (OR, 2.3; 95% CI, 1.9-2.8), and current smokers had even higher risks. AAA was significantly associated with established coronary and peripheral arterial disease and a waist:hip ratio greater than 0.9; men who regularly undertook vigorous exercise had a lower risk (OR, 0.8; 95% CI, 0.7-1.0).


CONCLUSIONS
Ultrasound screening for AAA is acceptable to men in the likely target population. AAA shares some but not all of the risk factors for occlusive vascular disease, but the scope for primary prevention of AAA in later life is limited.
Jamrozik
K
K
Department of Public Health, University of Western Australia, Nedlands. konrad@dph.uwa.edu.au
Norman
P E
PE
Spencer
C A
CA
Parsons
R W
RW
Tuohy
R
R
Lawrence-Brown
M M
MM
Dickinson
J A
JA
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014463:Ultrasonography; D014904:Western Australia / Q000453:epidemiology