No Significant Survival Benefits With Abdominal Aneurysm Screenings in Older Men

Research published online in JAMA Internal Medicine suggests the use of administrative databases, such as the electoral roll, to identify and invite men for abdominal aortic aneurysms (AAA) screening increased the detection rate but mortality was not significantly reduced. 

The newly published long-term analysis of the Australian study included 19,249 older men who were invited for screening; 12,203 (63.4%) were ultimately screened. between April 1996 and March 1999 and 19,231 controls who were not screened. All participants were originally identified through voter registration records.

Over an average of 12.8 years of follow-up (range of 11.6 to 14.2 years), more elective operations (536 vs 414, P < .001) and fewer ruptured AAAs (72 vs 99, P = .04) were observed in the invited group compared with the control group.

Researchers found no “meaningful differences in all-cause, cardiovascular, and other mortality risks.” Among men aged 65 to 74, the AAA mortality rate in the invited-to-screening group was 34.52 per 100,000 person-years (95% CI, 26.02-45.81) compared with 37.67 per 100,000 person-years (95% CI, 28.71-49.44) in the control group, for a rate ratio of 0.92 (95% CI, 0.62-1.36).

“Our results suggest that a national screening program using administrative databases, such as the electoral role, to identify men aged 64 to 83 years or 65 to 74 years is unlikely to be effective,” the researchers wrote.

They concluded that the small, overall benefit of population-wide screening “does not mean that finding AAAs in suitable older men is not worthwhile, because deaths from AAAs in men who actually attended for screening were halved by early detection and successful treatment.”—Amanda Del Signore