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BMJ. 2007 November 3; 335(7626): 899.
PMCID: PMC2048900
Abdominal Aortic Aneurysm

Screening reduces all cause mortality in men

Hisato Takagi, consultant cardiovascular surgeon, Norikazu Kawai, registrar, and Takuya Umemoto, consultant cardiovascular surgeon

Greenhalgh and Powell1 cite a recent Cochrane review, which reported that screening asymptomatic people for abdominal aortic aneurysm (AAA) significantly reduced not all cause but AAA related mortality in men aged 65-79. The review, however, excluded some recent studies with long follow-up.2 3 4 Therefore, we performed a meta-analysis of randomised controlled studies with long follow-up of screening for AAA in men (both AAA related and all cause mortality).5

Our comprehensive search identified four reports—the Chichester study (over 15 year follow-up),2 the Viborg country study (median 9.6 year follow-up),3 the Western Australia study (median 3.6 year follow-up), and the multicentre aneurysm screening study (mean 7.1 year follow-up).4 Pooled analysis of the four reports showed a statistically significant reduction in AAA related mortality (risk difference −0.25%, 95% confidence interval −0.46% to −0.04%) and all cause mortality (−1.06%, −1.81% to −0.31%) with screening relative to control in a random effects model.5

Thus, our meta-analysis,5 an update of the Cochrane review, showed that screening for AAA significantly reduced not merely AAA related but also all cause mortality in men aged >65 years.

Notes

Competing interests: None declared.

References

1. Greenhalgh R, Powell J. Screening for abdominal aortic aneurysm. BMJ 2007;335:732-3. (13 October.) [PMC free article] [PubMed]
2. Ashton HA, Gao L, Kim LG, Druce PS, Thompson SG, Scott RA. Fifteen-year follow-up of a randomized clinical trial of ultrasonographic screening for abdominal aortic aneurysms. Br J Surg 2007;94:696-701. [PubMed]
3. Lindholt JS, Juul S, Fasting H, Henneberg EW. Preliminary ten year results from a randomised single centre mass screening trial for abdominal aortic aneurysm. Eur J Vasc Endovasc Surg 2006;32:608-14. [PubMed]
4. Kim LG, P Scott RA, Ashton HA, Thompson SG; Multicentre Aneurysm Screening Study Group. A sustained mortality benefit from screening for abdominal aortic aneurysm. Ann Intern Med 2007;146:699-706. [PubMed]
5. Takagi H, Tanabashi T, Kawai N, Umemoto T. Screening for abdominal aortic aneurysm reduces both aneurysm-related and all-cause mortality. J Vasc Surg (in press).

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