title: The impact of decreasing abdominal aortic aneurysm prevalence on a local aneurysm screening programme.
abstract: OBJECTIVE
  The NHS Abdominal Aortic Aneurysm Screening Programme (NAAASP), based on the Multicentre Aneurysm Screening Study (MASS) trial (2002), is being introduced across the UK. Recent studies have demonstrated a decline in prevalence of abdominal aortic aneurysm (AAA). The aim of this study was to examine the effect of this on screening workload.
  
  
  METHODS
  A model was developed to predict screening and surgical workload for a screening centre (Bristol - population 1,123,203). Workload was compared using data from MASS with data from the "Early Implementers" (EI) of NAAASP.
  
  
  RESULTS
  Modelling for 2011/2012 using EI data predicted significantly fewer men diagnosed with an AAA compared to MASS data [84 (EI) versus 198 (MASS) p < 0.0001] and fewer referrals to a vascular surgeon for AAA repair [10 (EI) versus 30 (MASS) p = 0.0002). This difference became more marked with time (2015/16: 90 (EI) versus 212 (MASS) men diagnosed with an AAA (p < 0.0001) and 29 (EI) versus 71 (MASS) referred to a vascular surgeon (p < 0.0001)). From 2015/16 there was also a significant reduction in the predicted number of ultrasound scans.
  
  
  CONCLUSIONS
  Modelling screening activity based on contemporary epidemiological data demonstrates a significant reduction in workload compared to MASS data. This has implications for workforce planning, the introduction of new screening centres and the future of NAAASP.
authors.affiliation: Department of Vascular Surgery, Bristol Royal Infirmary, United Hospitals Bristol NHS Trust, Upper Maudlin Street, Bristol BS2 8HW, UK. rosie_darwood@btinternet.com
authors.forename: R J
authors.initials: RJ
authors.lastname: Darwood
authors.forename: M J
authors.initials: MJ
authors.lastname: Brooks
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D015203:Reproducibility of Results; D006113:United Kingdom / Q000453:epidemiology; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data* / Q000639:trends; D016526:Workload / Q000706:statistics & numerical data*