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Safety of men with abdominal aortic aneurysms (AAA) under surveillance in an NHS screening programme

Clare Oliver-Williams and collaborators have studied the safety of men with small to medium abdominal aortic aneurysms (AAA) who were put under surveillance in an NHS screening programme.

Population screening for AAA is ongoing in several countries, and has been shown to reduce AAA-related mortality by up to 50%. Most men who screen positive have an AAA below the referral threshold for treatment and are entered into an ultrasound surveillance programme.

This study looked at the risk of ruptured AAA in men under surveillance. In total, more than 18,000 men were included. Of these, 31 men suffered a ruptured AAA during the follow-up. Twenty-nine men died of the rupture, and 952 men died of other causes during the surveillance.

The overall risk of ruptured AAA varied between 0.03% for small (3-4.4cm) aneurysms and 0.4% for the largest (5-5.4cm) aneurysms. Men with aneurysms 5.5cm or larger were referred to treatment and were excluded from the surveillance programme.

The study concluded that men with small and medium screen-detected AAA are safe provided they are enrolled in a surveillance program, and that there is no evidence that the current referral threshold of 5.5cm should be changed.

This study was published in Circulation.

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