Screening for abdominal aortic aneurysm: is opportunistic detection a realistic alternative?

Abstract

To determine whether abdominal aortic aneurysms (AAA) may be detected during investigation for concurrent disease and to assess whether opportunistic detection is a feasible alternative to a formal screening programme. A prospective review of previous investigations in subjects attending for aortic screening. 276 men aged 65-80 attended the Chichester AAA screening programme. They were asked whether they had consulted their General Practitioner and whether they had undergone radiological investigation within the preceding 5 years. Two-hundred and sixty-one subjects had consulted their General Practitioner (94.6%) within the past 5 years. Fifty-six patients had been investigated with radiological imaging: in 22 cases (8.0%) the investigation had the potential to detect an AAA. The opportunistic detection rate was 0.4% (one AAA) in comparison to 12.0% for the screening programme (33 AAA). Imaging investigations with the potential to pick up AAA failed to detect five out of six aneurysms in this group. Opportunistic screening for AAA is not a realistic alternative to a formal screening programme but may improve the detection rate in the community.