Meta-analysis of the current prevalence of screen-detected abdominal aortic aneurysm in women

Abstract

Background: Although women represent an increasing proportion of those presenting with abdominal aortic aneurysm (AAA) rupture, the current prevalence of AAA in women is unknown. The contemporary population prevalence of screen-detected AAA in women was investigated by both age and smoking status.

Methods: A systematic review was undertaken of studies screening for AAA, including over 1000 women, aged at least 60 years, done since the year 2000. Studies were identified by searching MEDLINE, Embase and CENTRAL databases until 13 January 2016. Study quality was assessed using the Newcastle-Ottawa scoring system.

Results: Eight studies were identified, including only three based on population registers. The largest studies were based on self-purchase of screening. Altogether 1 537 633 women were screened. Overall AAA prevalence rates were very heterogeneous, ranging from 0·37 to 1·53 per cent: pooled prevalence 0·74 (95 per cent c.i. 0·53 to 1·03) per cent. The pooled prevalence increased with both age (more than 1 per cent for women aged over 70 years) and smoking (more than 1 per cent for ever smokers and over 2 per cent in current smokers).

Conclusion: The current population prevalence of screen-detected AAA in older women is subject to wide demographic variation. However, in ever smokers and those over 70 years of age, the prevalence is over 1 per cent.

Figure 1

Flow diagram of included studies. *Five duplicates between MEDLINE and Embase removed. AAA, abdominal aortic aneurysm

Figure 2

Pooled prevalence of abdominal aortic aneurysm in women aged at least 60 years: eight studies with screening performed between 2001 and 2012. Values in parentheses are 95 per cent confidence intervals

Figure 3

Prevalence of abdominal aortic aneurysm in women aged at least 60 years by 10‐year age groups. All women were aged 70 years in Svensjo et al. 27. Values in parentheses are 95 per cent confidence intervals

Figure 4

Prevalence of abdominal aortic aneurysm in women aged at least 60 years by smoking status. *Derubertis and colleagues29 reported data on smoking status in a subgroup of patients from the study by Savji et al.; the analysis included 10 012 women, mean age 69 years, with at least one cardiovascular risk factor screened between 2004 and 2006. Values in parentheses are 95 per cent confidence intervals