[Screening for abdominal aortic aneurysm saves lives at a reasonable cost].
Ruptured abdominal aortic aneurysms (AAA) cause 600 deaths per year in Sweden. As most patients are without symptoms prior to rupture, and about half the patients with a ruptured AAA die before arrival to hospital, the only way to reduce mortality substantially would be by screening and prophylactic treatment. The article reviews experience of screening for AAA from other European countries, data from the Swedish vascular registry (Swedvasc) and from the official registry of the causes of death in Sweden. With these data as input, a theoretical model of inviting all 65-year-old men in Sweden to take part in a screening programme for AAA is created. When the programme is fully developed after ten years, assuming an attendance rate of 75%, mortality in AAA would decrease from 630 to 346 per year. The total cost would increase from 154 to 161 million SEK (9 SEK = 1 Euro). The reason for the relatively minor increase in cost is explained by the fact that expensive emergency operations for ruptured AAA decrease by 50%. The cost per life saved would be 3,000-4,000 SEK. In conclusion, available data suggest that screening for AAA in Sweden would save many lives at a low cost.
Swedenborg
Jesper
J
Kärlkirurgiska kliniken, Karolinska sjukhuset, Stockholm. jesper.swedenborg@ks.se
Björck
Martin
M
Wanhainen
Anders
A
Bergqvist
David
D
D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D001019:Aortic Rupture / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control / Q000601:surgery; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration*; D011322:Primary Prevention / Q000191:economics; D016730:Program Development; D013548:Sweden / Q000453:epidemiology