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


CONCLUSIONS
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.


BACKGROUND
ISRCTN 00079388 (http://www.controlled-trials.com).
Ashton
H A
HA
Scott Research Unit, St Richard's Hospital, Chichester, UK. scottunit@rws-tr.nhs.uk
Gao
L
L
Kim
L G
LG
Druce
P S
PS
Thompson
S G
SG
Scott
R A P
RA
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D001019:Aortic Rupture / Q000000981:diagnostic imaging* / Q000401:mortality / Q000517:prevention & control; D002423:Cause of Death; D042241:Early Diagnosis; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening; D012307:Risk Factors; D015996:Survival Rate; D014463:Ultrasonography