The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Fifteen‐year follow‐up of a randomized clinical trial of ultrasonographic screening for abdominal aortic aneurysms. BJS 2007; 94: 696-701.

Published: 18th May 2007

Authors: H. A. Ashton, L. Gao, L. G. Kim, P. S. Druce, S. G. Thompson, R. A. P. Scott et al.

Background

Long‐term benefits of screening for abdominal aortic aneurysm (AAA) are uncertain. These are the final results of a randomized controlled screening trial for AAA in men, updating those reported previously. Benefit and compliance over a median 15‐year interval were examined.

Method

One group of men were invited for ultrasonographic AAA screening, and another group, who received standard care, acted as controls. A total of 6040 men aged 65–80 years were randomized to one of the two groups. Outcome was monitored in terms of AAA‐related events (surgery or death).

Results

In the group invited for screening, AAA‐related mortality was reduced by 11 per cent (from 1·8 to 1·6 per cent, hazard ratio 0·89) over the follow‐up interval. Screening detected an AAA in 170 patients; 17 of these died from an AAA‐related cause, seven of which might have been preventable. The incidence of AAA rupture after an initially normal scan increased after 10 years of follow‐up, but was still low overall (0·56 per 1000 person‐years).

Conclusion

Screening with a single ultrasonography scan still conferred a benefit at 15 years, although the results were not significant for this population size. Fewer than half of the AAA‐related deaths in those screened positive could be prevented. Registration number: ISRCTN 00079388 (http://www.controlled‐trials.com). Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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