OBJECTIVE - To analyse the benefits of screening older men for abdominal aortic aneurysms. METHODS - A hospital based screening trial concerning 13 500 65-73 year old men using B-mode ultrasonographic scanning. To improve the response rate the invited men could change their appointment, and nonresponders were reinvited. RESULTS - Results from the first year of the trial are presented. Among 4404 invited, 3344 (76%) were scanned. The primary response rate was 64.8%, but a further 11.2% were scanned after revised appointments or reinvitation. The whole infrarenal aorta could be visualised in 97-6%, and the distal part in 99.7% of the scans. The time taken for each scan was 9-7 minutes and the costs per scan were $9.50. One hundred and fifty three subjects (4.6%) had aortic diameters of 25-29 min, and 141 (4.2%) had an abdominal aortic aneurysm, 19 (0.6%) above 49 mm in diameter. CONCLUSION - In Denmark the short term costs and benefits of screening older men for abdominal aortic aneurysms seem realistic. Long term costs and benefits need to be investigated.
The incidence of abdominal aortic aneurysms (AAA) and ruptured AAA is increasing. One to three percent of deaths among 65-80 year-old males are caused by AAA. Sixty-six to ninety-five percent of ruptured AAA are lethal, while elective resection has a 3-6% operative mortality. Most AAA's are asymptomatic before rupture. Ultrasonographic scanning of the aorta takes below ten minutes with close to 100% sensitivity and specificity. The County of Viborg has started a randomized screening trial including 13,500 65-73 year-old males. Half of these are invited to the nearest hospital over a period of three years. In 1994-1995 4938 were invited and 3748 were scanned, resulting in an acceptance rate of 76%. The aorta was visible in 99.7%, and the total time consumption was 9.7 minutes per scan. The costs were 83.75 DKK per scan. One hundred and fifty-three (4.1%) had an AAA defined as an aortic diameter above 29 mm. Twenty were above 49 mm and were offered operation, i.e. 5.3 per thousand scans or 13% of the diagnosed AAA.
