Yield of Repeated Screening for Abdominal Aortic Aneurysm After a 4-Year Interval

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Abstract
ULTRASOUND SCREENING in older men to detect abdominal aortic aneurysm (AAA) has been a topic of considerable discussion in the medical literature. The only published randomized trial of ultrasound screening included 15 775 subjects and reported a substantial but statistically nonsignificant 41% reduction in AAA-related deaths in men.1 Similar trials are under way in Denmark2 and Western Australia.3 Most published cost-effectiveness analyses have judged ultrasound screening for AAA in men older than 60 years to be beneficial and associated with costs per year of life saved that are acceptable by current standards.4 The Vascular Surgery Society of the United Kingdom has recommended widespread screening of older men,5 whereas the Canadian and US Preventive Services Task Forces considered the evidence insufficient to make a recommendation,6,7 but plan to revisit the topic when more trial data are available (Michael Pignone, MD, written communication, 1998).