Screening for abdominal aortic aneurysms: the effects of age and social deprivation on screening uptake, prevalence and attendance at follow-up in the MASS trial

Objectives/setting: The effectiveness of screening programmes may be improved by knowledge of factors affecting screening uptake, disease prevalence and attendance for follow-up. Data from the Multicentre Aneurysm Screening Study (MASS) are used to examine the influences of age and social deprivation in the context of screening for abdominal aortic aneurysms (AAAs). Methods: In the MASS trial, a population-based sample of 34,000 men aged 65 to 74 received an invitation to screening. The associations of attendance at screening with age, social deprivation and season of the year when invited to attend were investigated using logistic regression analysis. Similar analyses were performed for AAA prevalence and attendance at recall scans. Results: Compared with men aged 65-69, those aged 70-74 were less likely to attend screening (79% vs 81%), had increased prevalence of AAA (6% vs 4%) and were less likely to attend for follow-up (79% vs 84%). Compared with those in the least deprived quartile, those in the most deprived quartile also were less likely to attend (75% vs 85%), had increased prevalence (6% vs; 4%) and were less likely to attend for follow-up (80% vs 83%). Season showed no significant association with attendance at initial screening. Conclusions: Higher age and social deprivation are associated with both poorer attendance at screening and follow-up, and having an AAA. This highlights the importance of promoting screening programmes, particularly to the more deprived populations.