Opportunistic screening for abdominal aortic aneurysm

Abstract

Objective - To contribute to the current debate on screening for abdominal aortic aneurysm (AAA). Setting - Radiology department oftheJohn Radcliffe Hospital, Oxford. Methods - The prevalence of AAA in 317 clinically referred male patients aged 65-74 undergoing abdominal ultrasonography with no clinical suspicion of an AAA was investigated over a period of one year. Results - Over the year 15/317 (5%) patients were found to have an aneurysm (defined as aortic diameter (30mm), with eight (3%) patients having an aortic diameter of 40mm. Six months later appropriate management for the AAA had been started for only four patients. A knowledge assessment questionnaire sent to 245 hospital clinicians and general practitioners' showed that 17 (12%) of the 139 respondents would initiate no review of patients found to have an aneurysm of 30-39mm and two would take no action with aneurysms of 40-49 rnrn, Thirty two (23%) respondents would seek advice on management for all categories of aneurysm, 14% from the radiologist. Conclusions - Opportunistic screening for AAA in men undergoing clinically indicated abdominal ultrasonography is easy, productive, without discernible cost, and discloses a prevalence of AAA comparable with that of population screening programmes. Routine opportunistic measurement of aortic diameter during abdominal ultrasonography in the at risk group would allow 12-15% of men aged 65-74 to be screened for AAA within five years without the need for any additional resources. © 1994, Medical Screening Society. All rights reserved.