Screening for Abdominal Aortic Aneurysm Questioned

By Amy Orciari Herman

Edited by William E. Chavey, MD, MS

A new Lancet study calls into question the benefits of screening for abdominal aortic aneurysm (AAA).

Researchers studied 25,000 Swedish men living in counties that, between 2006 and 2009, introduced one-time screening for all men aged 65 years, and 106,000 age-matched men in counties that hadn't yet introduced screening. Participants were followed for 6 years after screening (or matched date).

After multivariable adjustment, a small reduction in AAA mortality in the screened cohort was not statistically significant, and the researchers calculate that two deaths would be avoided for every 10,000 men invited for screening. Additionally, screening was associated with 49 potential overdiagnoses and 19 potentially avoidable elective surgeries per 10,000 men.

The researchers note that AAA mortality in Sweden began to decrease 10 years before screening was implemented, and decreased "by about the same rate" after screening began — likely due to reduced smoking. They write, "The clinical significance of the benefit of AAA screening today is therefore questionable."

Of note, in the U.S, guidelines primarily recommend AAA screening for older men who have ever smoked.