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Lessons learned about prevalence and growth rates of abdominal aortic aneurysms from a 25-year ultrasound population screening programme.

Abstract This study aimed to assess how the prevalence and growth rates of small and medium abdominal aortic aneurysms (AAAs) (3·0-5·4 cm) have changed over time in men aged 65 years, and to evaluate long-term outcomes in men whose aortic diameter is 2·6-2·9 cm (subaneurysmal), and below the standard threshold for most surveillance programmes.
PMID
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Twenty-year review of abdominal aortic aneurysm screening in men in the county of Gloucestershire, United Kingdom.

Authors

Mayor MeshTerms

Mass Screening

Keywords
Journal Title the british journal of surgery
Publication Year Start




PMID- 29265406
OWN - NLM
STAT- MEDLINE
DCOM- 20171229
LR  - 20171229
IS  - 1365-2168 (Electronic)
IS  - 0007-1323 (Linking)
VI  - 105
IP  - 1
DP  - 2018 Jan
TI  - Lessons learned about prevalence and growth rates of abdominal aortic aneurysms
      from a 25-year ultrasound population screening programme.
PG  - 68-74
LID - 10.1002/bjs.10715 [doi]
AB  - BACKGROUND: This study aimed to assess how the prevalence and growth rates of
      small and medium abdominal aortic aneurysms (AAAs) (3.0-5.4 cm) have changed over
      time in men aged 65 years, and to evaluate long-term outcomes in men whose aortic
      diameter is 2.6-2.9 cm (subaneurysmal), and below the standard threshold for most
      surveillance programmes. METHODS: The Gloucestershire Aneurysm Screening
      Programme (GASP) started in 1990. Men aged 65 years with an aortic diameter of
      2.6-5.4 cm, measured by ultrasonography using the inner to inner wall method,
      were included in surveillance. Aortic diameter growth rates were estimated
      separately for men who initially had a subaneurysmal aorta, and those who had a
      small or medium AAA, using mixed-effects models. RESULTS: Since 1990, 81 150 men 
      had ultrasound screening for AAA (uptake 80.7 per cent), of whom 2795 had an
      aortic diameter of 2.6-5.4 cm. The prevalence of screen-detected AAA of 3.0 cm or
      larger decreased from 5.0 per cent in 1991 to 1.3 per cent in 2015. There was no 
      evidence of a change in AAA growth rates during this time. Of men who initially
      had a subaneurysmal aorta, 57.6 (95 per cent c.i. 54.4 to 60.7) per cent were
      estimated to develop an AAA of 3.0 cm or larger within 5 years of the initial
      scan, and 28.0 (24.2 to 31.8) per cent to develop a large AAA (at least 5.5 cm)
      within 15 years. CONCLUSION: The prevalence of screen-detected small and medium
      AAAs has decreased over the past 25 years, but growth rates have remained
      similar. Men with a subaneurysmal aorta at age 65 years have a substantial risk
      of developing a large AAA by the age of 80 years.
CI  - (c) 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.
FAU - Oliver-Williams, C
AU  - Oliver-Williams C
AD  - Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care,
      Strangeways Research Laboratory, Cambridge, UK.
FAU - Sweeting, M J
AU  - Sweeting MJ
AD  - Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care,
      Strangeways Research Laboratory, Cambridge, UK.
FAU - Turton, G
AU  - Turton G
AD  - Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust,
      Cheltenham, UK.
FAU - Parkin, D
AU  - Parkin D
AD  - Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust,
      Cheltenham, UK.
FAU - Cooper, D
AU  - Cooper D
AD  - Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust,
      Cheltenham, UK.
FAU - Rodd, C
AU  - Rodd C
AD  - Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust,
      Cheltenham, UK.
FAU - Thompson, S G
AU  - Thompson SG
AD  - Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care,
      Strangeways Research Laboratory, Cambridge, UK.
FAU - Earnshaw, J J
AU  - Earnshaw JJ
AUID- ORCID: http://orcid.org/0000-0002-1125-6461
AD  - Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust,
      Cheltenham, UK.
CN  - Gloucestershire and Swindon Abdominal Aortic Aneurysm Screening Programme
LA  - eng
PT  - Journal Article
PL  - England
TA  - Br J Surg
JT  - The British journal of surgery
JID - 0372553
SB  - AIM
SB  - IM
MH  - Aged
MH  - Aortic Aneurysm, Abdominal/*diagnostic imaging/*epidemiology/pathology
MH  - Disease Progression
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - *Mass Screening
MH  - Models, Statistical
MH  - Prevalence
MH  - Ultrasonography
MH  - United Kingdom/epidemiology
EDAT- 2017/12/22 06:00
MHDA- 2017/12/30 06:00
CRDT- 2017/12/22 06:00
PHST- 2017/04/20 00:00 [received]
PHST- 2017/08/01 00:00 [revised]
PHST- 2017/09/02 00:00 [accepted]
PHST- 2017/12/22 06:00 [entrez]
PHST- 2017/12/22 06:00 [pubmed]
PHST- 2017/12/30 06:00 [medline]
AID - 10.1002/bjs.10715 [doi]
PST - ppublish
SO  - Br J Surg. 2018 Jan;105(1):68-74. doi: 10.1002/bjs.10715.