Research article

Is population screening for abdominal aortic aneurysm cost-effective?

Lars Ehlers¹ , Jan Sørensen² , Lotte Groth Jensen³ , Merete Bech³ and Mette Kjølby³

¹  Institute of Public Health, Aarhus University, Denmark

²  Centre for Applied Health Services Research and Technology Assessment, University of Southern Denmark, Denmark

³  Centre for Public Health, Denmark

author email corresponding author email

BMC Cardiovascular Disorders 2008, 8:32doi:10.1186/1471-2261-8-32

Published:	18 November 2008

Abstract

Background

Ruptured abdominal aortic aneurysm (AAA) is responsible for 1–2% of all male deaths over the age of 65 years. Early detection of AAA and elective surgery can reduce the mortality risk associated with AAA. However, many patients will not be diagnosed with AAA and have therefore an increased death risk due to the untreated AAA. It has been suggested that population screening for AAA in elderly males is effective and cost-effective. The purpose of this study was to perform a systematic review of published cost-effectiveness analyses of screening elderly men for AAA.

Methods

We performed a systematic search for economic evaluations in NHSEED, EconLit, Medline, Cochrane, Embase, Cinahl and two Scandinavian HTA data bases (DACEHTA and SBU). All identified studies were read in full and each study was systematically assessed according to international guidelines for critical assessment of economic evaluations in health care.

Results

The search identified 16 cost-effectiveness studies. Most studies considered only short term cost consequences. The studies seemed to employ a number of "optimistic" assumptions in favour of AAA screening, and included only few sensitivity analyses that assessed less optimistic assumptions.

Conclusion

Further analyses of cost-effectiveness of AAA screening are recommended.