Screening for Aortic Aneurysms in Older Men Decreases Mortality

April 18, 2007 — Ultrasound screening for aortic aneurysms in men, but not in women, aged 65 to 79 years is effective in decreasing mortality, according to the results of a review published in the April 18 issue of the Cochrane Database of Systematic Reviews.
Abdominal aortic aneurysm (AAA) is found in 5% to 10% of men aged 65 to 79 years, with the major complication being rupture that presents as a surgical emergency.
"The mortality after rupture is high, 80% for patients reaching hospital and 50% for those undergoing surgery for emergency repair," write P.A. Cosford and G.C. Leng, from the Cochrane Collaboration. "Currently elective surgical repair is recommended for aneurysms discovered to be larger than 5.5 cm to prevent rupture. There is interest in population screening to detect, monitor and repair abdominal aortic aneurysms before rupture."
To determine the effects of screening asymptomatic individuals for AAA on mortality, subsequent treatment, quality of life, and cost effectiveness of screening, the Cochrane Peripheral Vascular Diseases Group searched their Trials Register through January 26, 2007, and Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library through Issue 1, 2007.
Two authors independently evaluated randomized controlled trials of population screening for AAA and extracted data from 4 studies enrolling 127,891 men and 9342 women. Two of the studies were conducted in the United Kingdom, 1 in Denmark, and 1 in Australia. Only 1 trial included women; results for men and women were analyzed separately.