Most women 'unlikely to benefit' from aneurysm screening programme

July 27, 2018 by Ryan O'hare, Imperial College London
Credit: CC0 Public Domain

A national screening programme to detect abdominal aortic aneurysms in older men would be unlikely to benefit most women, new research has found.

Abdominal aortic aneurysms (AAAs) affect the body's largest blood vessel, the aorta, causing it to swell and in some cases rupture, with potentially life-threatening consequences.

In 2009, the NHS introduced ultrasound in men aged 65 and over in the UK to detect and treat the condition – which can be symptomless until the point of rupture.

Previous studies have shown that population screening programmes for men, in countries such as the UK, Sweden and the United States, can reduce AAA-related mortality by up to 40 per cent, although any reduction in all-cause mortality is small.

In the latest study, published in The Lancet, researchers wanted to see if in the UK, who are less likely to have AAAs, could also benefit from a similar screening programme.

A team including researchers from Imperial College London and the Universities of Leicester and Cambridge, and funded by the National Institute for Health Research, used datasets to simulate outcomes of a screening programme for women.

Little benefit

Credit: Imperial College London

They found that by UK standards an AAA screening programme for women, mimicking that in men, "would yield little benefit".

Their analysis revealed that screening women – based on the current criteria for men – could potentially reduce deaths from AAA among women by 7 per cent for those aged 65 to 75 and by 3 per cent from age 65 to 95, but it would require 3,900 screening invitations to avoid one AAA-death, and is unlikely to be cost-effective.

Cost effective?

"We used a sophisticated computer model to find out whether an AAA screening programme for women would be cost-effective," said Professor Simon Thompson, a statistician based at the University of Cambridge and who led the project. "This showed that if women were also offered screening, only a very small number would benefit and the cost of such a screening programme would not be a good use of NHS resources."

However, the team add that more research is needed to understand the condition in women and understand the additional risk.

Professor Janet Powell, Visiting Professor at Imperial's Department of Surgery & Cancer and co-author of the paper, said: "We need better information on aortic sizes of women at different ages, to see whether we have been using the wrong diagnostic threshold in women and therefore whether the population prevalence has been underestimated in women. We also need to reduce the operative mortality in women and find out whether screening has adverse effects on quality of life.

"A future step would be to see if there are certain groups of women at higher risk of the disease who might benefit from a targeted screening programme."

Explore further: Computer simulation suggests risk-based breast screening could have benefits

More information: Michael J Sweeting et al. Analysis of clinical benefit, harms, and cost-effectiveness of screening women for abdominal aortic aneurysm, The Lancet (2018). DOI: 10.1016/S0140-6736(18)31222-4

Related Stories

Computer simulation suggests risk-based breast screening could have benefits

July 6, 2018
When it comes to breast cancer screening, there's a delicate balance between the benefits and harms.

Study questions the benefits of abdominal aortic aneurysm screening in men

June 15, 2018
Screening for abdominal aortic aneurysm—swelling of the major artery in the abdomen, which can cause sudden death if it ruptures—may not substantially reduce deaths from the condition, according to a Swedish cohort study ...

More than two-thirds of cervical cancer deaths prevented by screening

September 19, 2016
Cervical screening prevents 70 per cent of cervical cancer deaths and if all eligible women regularly attended screening this would rise to 83 per cent, according to research led by Queen Mary University of London (QMUL).

Why are women at high breast cancer risk not having supplemental MRI screening?

March 19, 2018
Women at high lifetime breast cancer risk might benefit from breast MRI screening in addition to routine mammography, but a new study shows that breast MRI is greatly underutilized even though access is widely available. ...

Screening has had 'little impact' on falling breast cancer deaths in the Netherlands

December 5, 2017
Breast screening in the Netherlands seems to have had a marginal effect on breast cancer mortality over the past 24 years, suggests research in The BMJ today.

HPV jab means women only need 3 cervical screens in a lifetime

November 10, 2017
Women may only need three cervical screens in their lifetime if they have been given the human papillomavirus (HPV) vaccine, according to a new study published in the International Journal of Cancer today (Friday).

Recommended for you

Two ways cancer resists treatment are actually connected, with one activating the other

December 18, 2018
Drugs that target BRAF and MEK in cancer have shown promise in treating a subset of melanoma that carries a mutation in the BRAF gene, but drug resistance usually emerges, reversing the benefit of these drugs and limiting ...

HPV discovery raises hope for new cervical cancer treatments

December 18, 2018
Researchers at the University of Virginia School of Medicine have made a discovery about human papillomavirus (HPV) that could lead to new treatments for cervical cancer and other cancers caused by the virus.

Vaccine, checkpoint drugs combination shows promise for pancreatic cancers

December 18, 2018
Researchers at the Johns Hopkins Kimmel Cancer Center discovered a combination of a cancer vaccine with two checkpoint drugs reduced pancreatic cancer tumors in mice, demonstrating a possible pathway for treatment of people ...

Researchers identify ways breast cancer avoids immune system detection

December 18, 2018
Recent breakthroughs in immunotherapy are making a huge difference in treating some forms of cancer, especially metastatic cancer. But breast cancer has proven a tricky foe for this new therapy, and an interdisciplinary team ...

Metal chemotherapy drugs boost the impact of immunotherapy in cancer

December 18, 2018
Due to their powerful tumour-killing effect, metal-based chemotherapies are frequently used in cancer treatment. However, it was hitherto assumed that they damaged the immune system, because of their cytotoxic (cell-damaging) ...

10-year follow-up after negative colonoscopies linked to lower colorectal cancer risk

December 17, 2018
Ten years after a negative colonoscopy, Kaiser Permanente members had 46 percent lower risk of being diagnosed with and were 88 percent less likely to die from colorectal cancer compared with those who did not undergo colorectal ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.