Journal
BRITISH JOURNAL OF SURGERY
Volume 99, Issue 12, Pages 1649-1655Publisher
WILEY-BLACKWELL
DOI: 10.1002/bjs.8897
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Funding
- The UK Medical Research Council [G0601031]
- British Heart Foundation [RG/08/014/24067] Funding Source: researchfish
- Medical Research Council [MC_EX_G0601031, MC_U105260792] Funding Source: researchfish
- MRC [MC_U105260792, MC_EX_G0601031] Funding Source: UKRI
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Background: The long-term effects of abdominal aortic aneurysm (AAA) screening were investigated in extended follow-up from the UK Multicentre Aneurysm Screening Study (MASS) randomized trial. Methods: A population-based sample of men aged 6574 years were randomized individually to invitation to ultrasound screening (invited group) or to a control group not offered screening. Patients with an AAA (3.0 cm or larger) detected at screening underwent surveillance and were offered surgery after predefined criteria had been met. Cause-specific mortality data were analysed using Cox regression. Results: Some 67 770 men were enrolled in the study. Over 13 years, there were 224 AAA-related deaths in the invited group and 381 in the control group, a 42 (95 per cent confidence interval 31 to 51) per cent reduction. There was no evidence of effect on other causes of death, but there was an overall reduction in all-cause mortality of 3 (1 to 5) per cent. The degree of benefit seen in earlier years of follow-up was slightly diminished by the occurrence of AAA ruptures in those with an aorta originally screened normal. About half of these ruptures had a baseline aortic diameter in the range 2.52.9 cm. It was estimated that 216 men need to be invited to screening to save one death over the next 13 years. Conclusion: Screening resulted in a reduction in all-cause mortality, and the benefit in AAA-related mortality continued to accumulate throughout follow-up. Registration number: ISRCTN37381646 (http://www.controlled-trials.com). Copyright (c) 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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