Community-based, nonprofit organization-sponsored ultrasonography screening program for abdominal aortic aneurysms is effective at identifying occult aneurysms

Abstract

Early diagnosis of abdominal aortic aneurysm (AAA), prior to rupture, is vital for optimizing patient survival. An abdominal ultrasonography examination of an asymptomatic individual to check for the presence of an AAA, however, is not presently reimbursed by health insurance in the United States. This article reports the results of one nonprofit, community-based screening program, run by Aneurysm Outreach, Inc. (AOI; www.alink.org). AOI offered free screening for AAA to anyone who met the criteria of being (1) over 60 years old; (2) over 50 years old, male, and with positive family history for AAA; or (3) over 55 years old, female, and with positive family history for AAA. AOI organized 21 ultrasonographic screening events between September 2001 and November 2004, and the number of participants per event varied from 24 to 240. Altogether 3,088 individuals met the screening criteria and 22 of them were already known to have AAAs. Thirty-six (1.2%) individuals were excluded from the final analysis due to poor quality of the ultrasonographic images. Among the remaining 3,030 individuals, a dilatation of the aorta was detected and confirmed in 61 (2.0%) individuals, in 4.3% of the screened males and in 0.6% of the screened females. Thirteen individuals had their AAAs repaired surgically. The frequencies of males and current smokers were significantly higher in the AAA group than in the group with normal-size aorta (male AAA 83.6% vs. normal 42.0%, p < 0.0001; smoker AAA 54.9% vs. normal 18.1%, p < 0.0001). The mean age was significantly higher in the AAA group than in the group with normal-size aorta (AAA 71.0 +/- 6.2 vs. normal 68.4 +/- 7.0, p = 0.005). In conclusion, the results of this community-based free ultrasonographic screening program are in agreement with randomized controlled screening programs and emphasize the need for systematic screening programs and the importance of finding individuals harboring AAAs before their rupture.