Effectiveness and cost of screening for abdominal aortic aneurysm: results of a population screening program.
OBJECTIVE
We undertook this study to calculate the cost per life-year gained in the first round of a screening program for abdominal aortic aneurysm (AAA) and to estimate the costs in a subsequent round.


METHODS
This was an intervention study, with follow-up for ruptured aneurysms. Men older than 50 years were screened for asymptomatic AAA. Outcome measures included cost per life-year saved and number of men needed to be screened to save one life.


RESULTS
The incidence of ruptured AAA was 2.6 per 10,000 person- years in the screening group and 7.1 per 10,000 person-years in the control group. Screening is estimated to have prevented 10.8 ruptured AAA and 8 deaths per year, gaining 51 life-years per year for the study population, and to have reduced the incidence of ruptured AAA by 64% (95% CI, 42%-77%). Each life-year gained during the first screening round cost $1107. To save one life, 1000 men need to be screened and 5 elective operations performed. We predict that a second round of screening can be cost neutral.


CONCLUSIONS
The cost-effectiveness of screening for AAA compares favorably with screening programs for other disorders in adults.
Wilmink
A B M
AB
Department of Vascular Surgery, University of Birmingham, Birmingham, England, United Kingdom.
Quick
C R G
CR
Hubbard
C Sff
CS
Day
N E
NE
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000191:economics*; D001019:Aortic Rupture / Q000453:epidemiology* / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D011159:Population Surveillance; D012422:Rupture, Spontaneous; D016019:Survival Analysis; D006113:United Kingdom