The longer-term mortality benefit and cost-effectiveness for abdominal aortic aneurysm screening are uncertain.
Dr Lois Kim and colleagues from England estimated the benefits of abdominal aortic aneurysm-related and all-cause mortality.
The research team also assessed cost-effectiveness of ultrasonography screening for abdominal aortic aneurysm.
The team evaluated a group that was invited to screening compared with a group that was not invited at a mean 7-year follow-up period.
|The cost-effectiveness was $7600 per life-year gained based on all-cause death|
|Annals of Internal Medicine|
The researchers conducted a randomized trial in 4 centers, and a population-based sample of 67,770 men with a mean age of 65 to 74 years.
Patients with an detected at screening had surveillance, and were offered surgery after predefined criteria there met.
The team obtained mortality data on the national database.
Unit costs were taken from large samples, and applied to individual event data for the cost analysis.
The researchers found that the hazard ratio was 0.5 for abdominal aortic aneurysm-related mortality in the group invited for screening.
The rupture rate in men with normal results on initial ultrasonography has remained low.
The research team observed that the rupture rate was 0.5 per 10,000 person-years.
In terms of all-cause mortality, the observed hazard ratio was about 1 per 10,000.
At the 7-year follow-up, cost-effectiveness was estimated at $19,500 per life-year gained based on abdominal aortic aneurysm-related mortality.
The researchers noted that the cost-effectiveness was $7600 per life-year gained based on all-cause death.
Dr Kim's team commented, "Inclusion of deaths from aortic aneurysm at an unspecified site, which may include some thoracic aortic aneurysms, may have underestimated the treatment effect."
"Our results show that the early mortality benefit of screening ultrasonography for abdominal aortic aneurysm is maintained in the longer term, and that the cost-effectiveness of screening improves over time."