Fifteen-year follow-up of a randomized clinical trial of ultrasonographic screening for abdominal aortic aneurysms

Br J Surg. 2007 Jun;94(6):696-701. doi: 10.1002/bjs.5780.


Background: Long-term benefits of screening for abdominal aortic aneurysm (AAA) are uncertain. These are the final results of a randomized controlled screening trial for AAA in men, updating those reported previously. Benefit and compliance over a median 15-year interval were examined.

Methods: One group of men were invited for ultrasonographic AAA screening, and another group, who received standard care, acted as controls. A total of 6040 men aged 65-80 years were randomized to one of the two groups. Outcome was monitored in terms of AAA-related events (surgery or death).

Results: In the group invited for screening, AAA-related mortality was reduced by 11 per cent (from 1.8 to 1.6 per cent, hazard ratio 0.89) over the follow-up interval. Screening detected an AAA in 170 patients; 17 of these died from an AAA-related cause, seven of which might have been preventable. The incidence of AAA rupture after an initially normal scan increased after 10 years of follow-up, but was still low overall (0.56 per 1000 person-years).

Conclusion: Screening with a single ultrasonography scan still conferred a benefit at 15 years, although the results were not significant for this population size. Fewer than half of the AAA-related deaths in those screened positive could be prevented.

Registration number: ISRCTN 00079388 (

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / diagnostic imaging*
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / surgery
  • Aortic Rupture / diagnostic imaging*
  • Aortic Rupture / mortality
  • Aortic Rupture / prevention & control
  • Cause of Death
  • Early Diagnosis
  • Elective Surgical Procedures / statistics & numerical data
  • Follow-Up Studies
  • Humans
  • Male
  • Mass Screening
  • Risk Factors
  • Survival Rate
  • Ultrasonography

Associated data

  • ISRCTN/ISRCTN00079388