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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.
Competing interests: None declared.