Abdominal aortic aneurysm screening
An abdominal aortic aneurysm (AAA) is a swelling of the aorta, the main artery in the body. Men across all 4 nations of the UK including Scotland in their 65th year are invited to be screened for AAA. The screening programme aims to reduce the mortality associated with the risk of AAA rupture in men aged 65 years and older.
The screening involves an ultrasound scan of the abdomen. Appointments take place at local screening centres across Scotland.
Most men will have a negative result (they have no aneurysm). An aneurysm will be monitored if detected through screening. If the aneurysm is small, an ultrasound scan will be offered every year. If the aneurysm is medium, an ultrasound scan will be offered every three months. If the aneurysm is large, a referral will be made to a consultant surgeon.
- It is estimated that about 1 in 20 men aged 65 and over, in Scotland, have an abdominal aortic aneurysm.
- The condition is most common in men aged 65 and over, and usually there are no symptoms.
- Up to 170 lives a year in Scotland could be saved through the AAA screening programme.
- Overall uptake of the AAA screening programme is high with 84% of men in Scotland attending their appointment.
- Early detection, and treatment of AAA greatly reduces the chance of rupture.
AAA surveillance and prevalence
Public Health Scotland annually publishes the Scottish Abdominal Aortic Aneurysm (AAA) screening programme statistics which has more information on the Key Performance Indicators (KPIs) and screening trends over time.
Continuous research also monitors and influences the programme. This latest study aimed to ensure the safety of men under surveillance in the National Health Service AAA Screening Programme (NAAASP) and to examine other causes of death in the surveillance cohort.
Inequalities
There are inequalities in the risk factors for AAA, and in the uptake of AAA screening.
- Men are 6 times more likely to have an abdominal aortic aneurysm than women.
- Men are at higher risk if they are smokers, have high cholesterol, have high blood pressure and have a family history of aneurysms.
- Uptake of AAA screening is lower in the most deprived areas.
Several risk factors for AAA are known, including:
- smoking
- age
- sex (men are more at risk)
- a family history of AAA
- hypertension
- atherosclerosis
- hyperlipidaemia
- being Caucasian.
Diabetes is thought to protect against the formation of AAA but may also increase the risk of rupture. People from areas of high deprivation are more likely to have an abdominal aortic aneurysm than the least deprived. It is unknown what effect deprivation has upon mortality from abdominal aortic aneurysm.
Health inequalities can occur at any point in the AAA screening pathway. Therefore, it is important for partners to work together to ensure that all eligible men have an equal opportunity of awareness, knowledge, and access to AAA screening.
Local and national action
The AAA screening programme was implemented in Scotland in 2012. The Scottish Government outlined their plans for implementation in a Chief Executive Letter (PDF, 134 KB) (external website) in 2010.
NHS Boards ensure that the AAA screening service meets the Healthcare Improvement Scotland standards (2011) (external website).
The NICE Guidelines: Abdominal aortic aneurysm: diagnosis and management (external website) covers diagnosing and managing abdominal aortic aneurysms, giving evidence-based recommendations. The status of the guidelines is being reviewed for the screening programme in Scotland.
The Circulation Foundation is a UK charity dedicated to vascular health and offers support and advice.
A screening pathway and frequently asked questions has been developed for health professionals to support the AAA programme.
Information for professionals
A screening pathway and frequently asked questions has been developed for health professionals to support the AAA programme.
Information for the public
NHS inform hosts AAA screening information for the public. This includes information in audio format and British Sign Language format.