Randomized clinical trial of screening for abdominal aortic aneurysm in women

Abstract

Background: Screening for abdominal aortic aneurysm (AAA) is commonly restricted to men. Recent studies have indicated a possible increase in deaths due to ruptured AAA in women, and a higher rate of rupture in women than in men. The present report details results from a randomized controlled trial that assessed the effects of screening women for AAA. Methods: Some 9342 women aged 65–80 years were entered into the trial and randomized to age-matched screen and control groups. A single ultrasonographic scan was offered to women in the screening arm of the study. Women with an AAA received follow-up scans, and were considered for elective surgery if certain criteria were met. Results: The prevalence of AAA was six times lower in women (1·3 per cent) than in men (7·6 per cent). Over 5- and 10-year follow-up intervals, the incidence of rupture was the same in the screened and control groups of women. Conclusion: Screening women for AAA is neither clinically indicated nor economically viable.