Should you be screened for abdominal aortic aneurysm?

If you’re a man aged 64 or approaching your 65th birthday, you should soon be invited for abdominal aortic aneurysm (AAA) screening. But what is AAA, and should you be concerned about it?

According to the NHS, men aged 65 and older are most at risk of AAA. An AAA develops when the aorta – the main blood vessel in the body – weakens and starts to expand. The problem is that as they expand, large AAAs can burst and cause life-threatening internal bleeding. This is medical emergency, and in around 80 out of 100 cases, it’s fatal.

However, screening aims to detect if there’s a bulge or swelling in the aorta. This involves a quick and painless ultrasound scan of your abdomen – similar to the scan women have when they’re pregnant.

Around 15 in every 1,000 men who are screened are found to have an AAA. There are three classifications of AAA – small, medium and large:

Small A small AAA measures 3 – 4.4cm in diameter and affects just over one percent of men who are screened. No treatment is usually necessary at this stage, but you will usually be invited back for screening once a year.

Medium Around 0.5 percent of men screened have a medium AAA, which measures 4.5 – 5.4cm in diameter. Again you won’t need treatment, as the chance of your AAA bursting is small. You will, however, be invited back for more regular screening, usually about once every three months.

Large If you have a large AAA your aorta measures 5.5cm or more in diameter (0.1 percent of men screened have a large AAA). This means your AAA has a high risk of bursting if left untreated, and if affected you will be referred to a surgeon to discuss your treatment options within two weeks. Surgery does carry a risk of serious complications, but these are thought to be smaller than the risk of not having an AAA treated and repaired surgically.

Meanwhile the 985 in every 1,000 men screened who don’t have an AAA benefit from the reassurance that they don’t have a problem.

So if you’re invited for the test, what should you do?

To help you decide, the NHS and Public Health England have put together a quick guide to the potential risks and benefits of either attending or not attending AAA screening. Here are some of the main points you should be aware of:

  • AAA screening is thought to prevent around 2,000 premature deaths from ruptured AAAs each year through early detection, monitoring and treatment.
  • About 25 out of every 10,000 men who don’t accept the invitation for screening die from an AAA within 10 years.
  • Most people who have an AAA don’t have any symptoms – so if you don’t go for your screening appointment, you won’t usually be able to tell if you have a problem.
  • About 15 in every 1,000 men screened have a small or medium AAA and are offered advice on what they can do to help the aneurysm getting bigger, including eating healthy foods, taking regular exercise and not smoking. Men with aneurysms 6.5cm wide or larger are advised to stop driving (though your licence will be reinstated if you have a large aneurysm that’s repaired successfully).
  • More than 98 out of every 100 patients survived planned surgery to repair an aneurysm.
  • If you have an undiagnosed aneurysm and it bursts, your chances of survival are about 20 in100.

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