Diverse Requirements for Efficient Population Screening for Abdominal Aortic Aneurysm
From Program Management to Maintaining Skills in Open Repair
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Article, see p 1141
The purpose of health screening is to identify people who are at higher risk of a specific disease or health problem so that early treatment can be offered or information given to help them make informed decisions. Because most abdominal aortic aneurysms (AAAs) are silent or asymptomatic until the usually catastrophic event of aneurysm rupture, the purpose of screening for AAA is to prevent aneurysm rupture by an appropriately timed intervention of aneurysm repair. Those with an aneurysm detected also can be targeted for secondary prevention to minimize future cardiovascular risk.
In the United States, the 1-time screening for AAA of men 65 to 75 years of age is only recommended. In Sweden and the United Kingdom, national screening programs for 65-year-old men are in place. The article by Wanhainen and colleagues1 in this issue of Circulation carefully reports the results of nationwide screening in Sweden. Complementary information from the nationwide screening program in England also has been reported recently.2 In both Sweden and England, aneurysm repair is recommended when the aneurysm diameter reaches 5.5 cm, and individuals with smaller aneurysms are kept under regular ultrasonographic surveillance until this threshold is reached.
In Sweden, 84% of men accepted the invitation to aneurysm screening, although some men had to pay a small fee …