Is population screening for abdominal aortic aneurysm cost-effective?
BACKGROUND
Ruptured abdominal aortic aneurysm (AAA) is responsible for 1-2% of all male deaths over the age of 65 years. Early detection of AAA and elective surgery can reduce the mortality risk associated with AAA. However, many patients will not be diagnosed with AAA and have therefore an increased death risk due to the untreated AAA. It has been suggested that population screening for AAA in elderly males is effective and cost-effective. The purpose of this study was to perform a systematic review of published cost-effectiveness analyses of screening elderly men for AAA.


METHODS
We performed a systematic search for economic evaluations in NHSEED, EconLit, Medline, Cochrane, Embase, Cinahl and two Scandinavian HTA data bases (DACEHTA and SBU). All identified studies were read in full and each study was systematically assessed according to international guidelines for critical assessment of economic evaluations in health care.


RESULTS
The search identified 16 cost-effectiveness studies. Most studies considered only short term cost consequences. The studies seemed to employ a number of "optimistic" assumptions in favour of AAA screening, and included only few sensitivity analyses that assessed less optimistic assumptions.


CONCLUSIONS
Further analyses of cost-effectiveness of AAA screening are recommended.
Ehlers
Lars
L
Institute of Public Health, Aarhus University, Denmark. lars.ehlers@stab.rm.dk
Sørensen
Jan
J
Jensen
Lotte Groth
LG
Bech
Merete
M
Kjølby
Mette
M
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D001019:Aortic Rupture / Q000191:economics* / Q000517:prevention & control / Q000601:surgery; D003362:Cost-Benefit Analysis; D003658:Decision Making, Computer-Assisted; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D011788:Quality of Life; D016540:Smoking Cessation / Q000191:economics; D014463:Ultrasonography / Q000191:economics*