Benefit, risks and cost-effectiveness of screening for abdominal aortic aneurysm

Rofo. 2010 Jul;182(7):573-80. doi: 10.1055/s-0029-1245140. Epub 2010 Jun 18.


Purpose: Abdominal aortic aneurysms (AAA) cause a considerable number of deaths. A ruptured AAA is associated with a mortality rate of 80%. The purpose of this study was to summarize the current evidence from published health economic models for the long-term effectiveness and cost-effectiveness of screening programs for AAA.

Materials and methods: Medical, economic and health technology assessment (HTA) databases were systematically searched for cost-effectiveness models up to October 2007. Only models with a lifetime time horizon of evaluating AAA screening in men over 65 years were included in the review. Study data were extracted, standardized and summarized in evidence tables and cost-effectiveness plots.

Results: We reviewed 8 cost-effectiveness models published between 1993 and 2007 comparing AAA screening and lack of screening in men over 60. One model yielded a loss of life-years at additional costs. The remaining seven models yielded gains in life expectancy ranging from 0.02 to 0.28LYs. Gains in quality-adjusted life expectancy reported by six of the seven models ranged from 0.015 to 0.059 QALYs. Incremental costs ranged from 96 to 721 Euros. Incremental cost-effectiveness ratios (ICER) ranged from 1443 to 13 299 Euros per LY or QALY gained.

Conclusion: Based on our analysis, the introduction of a screening program to identify AAA will probably gain additional life years and quality of life at acceptable extra costs. The target population for a screening program should be men 65 years and older.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aged
  • Aortic Aneurysm, Abdominal / diagnosis*
  • Aortic Aneurysm, Abdominal / economics*
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Rupture / diagnosis
  • Aortic Rupture / economics
  • Aortic Rupture / mortality
  • Cost-Benefit Analysis
  • Diagnostic Imaging / economics*
  • Germany
  • Humans
  • Male
  • Mass Screening / economics*
  • Middle Aged
  • Quality-Adjusted Life Years
  • Risk Factors
  • Sex Factors