Population-Based Study of Incidence of Acute Abdominal Aortic Aneurysms With Projected Impact of Screening Strategy

Background: current abdominal aortic aneurysm (aaa) screening in men age 65 might have limited impact on overall aaa death rates if incidence is moving to older ages. up-to-date population-based studies of age-specific incidence,risk factors,and outcome of acute aaa are needed to inform screening policy.methods and results: in a prospective,population-based study (oxfordshire,uk,2002-2014),the incidence and outcome of acute aaa events were determined. based on population projections and current incidence trends,the impact of screening strategies in the uk was estimated. over the 12-year period,103 incident acute aaa events occurred in the study population of 92 728. incidence/100 000/year was 55 in men ages 65 to 74 years,but increased to 112 at 75 to 85 and 298 at ≥85,with 66.0% of all events occurring at age ≥75 years. incidence at ages 65 to 74 was highest in male smokers (274),with 96.4% of events in men <75 years occurring in ever-smokers. extrapolating rates to the uk population,using trial evidence of screening efficacy,the current uk screening program would prevent 5.6% of aneurysm-related deaths (315 200 scans/year: 1426/death prevented,121/year-of-life saved). screening only male smokers age 65 and then all men at age 75 would prevent 21.1% of deaths (247 900 scans/year; 297/death prevented,34/year-of-life saved). by 2030,91.0% of deaths will occur at age ≥75,61.6% at ≥85,and 28.6% in women.conclusions: given that two thirds of acute aaa occurred at ≥75 years of age,screening older age groups should be considered. screening nonsmokers at age 65 is likely to have very little impact on aaa event rates. © 2015 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.