Hospital costs and benefits of screening for abdominal aortic aneurysms. Results from a randomised population screening trial

Objectives: to analyse tire hospital costs and benefits of screening older males for abdominal aortic aneurysm (AAA). Methods and material: in 1994 a hospital-based screening trial of 12 658 65-73-year-old males was started. AAA >5 cm were referred for surgery, The remaining AAA were offered annual scans. Those with aortic ectasia were rescreened at 5 yearly intervals. AAA-operations and hospital AAA-related deaths were researched. The costs of screening, surveillance, and treatment were also registered. Results: the attendance rate was 76%; of whom 191 (4.0%) find AAA. Meant observation time was 5.13 years. Sixty in the screened and 41 in tire control group were operated (p=0.06), of which 7 and 27 respectively were operated as all emergency (p<0.001), and 6 and 19 respectively died due to AAA (p=0.009). The costs per scan were 83.50 DKK, 81400 DKK per emergency operation (71485 DKK after screening), and 117000 DKK per emergency operations. The cost per prevented hospital death was 67855 DKK equivalent to approximately life year saved approx. 7540 DKK (GBP1=12 DKK). Conclusion: screening appears to reduce hospital AAA mortality and to be cost-effective.