title: Abdominal Aortic Aneurysm Screening Reduces All-Cause Mortality: Make Screening Great Again.
abstract: We performed an updated meta-analysis of the longest (≥13 years) follow-up results from 4 randomized controlled trials of abdominal aortic aneurysm (AAA) screening in ≥64-year-old men. Invitation to screening reduced all-cause mortality significantly according to time-to-event data (hazard ratio: 0.98; 95% confidence interval [CI]: 0.96-0.99; P = .003) despite no reduction according to dichotomous data (odds ratio [OR]: 0.99; 95% CI: 0.96-1.01; P = .23). Invitation to screening reduced AAA-related mortality significantly (OR: 0.66; 95% CI: 0.47-0.93; P = .02) but did not reduce non-AAA-related mortality (OR: 1.00; 95% CI: 0.98-1.02; P = .96). All-cause, AAA-related, and non-AAA-related mortalities were significantly lower in attenders than in nonattenders, in noninvitees, or in both. All-cause (OR: 1.41; 95% CI: 1.23-1.63; P < .00001) and non-AAA-related mortalities (OR: 1.39; 95% CI: 1.18-1.64; P < .0001) were significantly higher in nonattenders than in noninvitees. In conclusion, invitation to AAA screening in ≥64-year-old men reduced both all-cause and AAA-related mortalities significantly. All-cause and non-AAA-related mortalities were significantly higher in nonattenders than in noninvitees, though both did not undergo screening.
authors.affiliation: 1 Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
authors.forename: Hisato
authors.initials: H
authors.lastname: Takagi
authors.affiliation: 2 Department of Cardiology, Detroit Medical Center, Detroit, MI, USA.
authors.forename: Tomo
authors.initials: T
authors.lastname: Ando
authors.affiliation: 1 Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Umemoto
mesh_terms: D000367:Age Factors; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D008297:Male; D008403:Mass Screening; D018579:Patient Selection; D012737:Sex Factors
keywords: abdominal aortic aneurysm; meta-analysis; mortality; screening