Two new studies have reached different conclusions on the cost-effectiveness of national aortic screening programmes.
Ruptured aortic aneurysms, caused by ballooning of the artery wall, cause the death of about 6,000 men in England and Wales every year.
The problem can be detected via ultrasound scan, so a national screening programme for men aged 65 began in the UK this spring. Support for the initiative came from the United Kingdom Multicentre Aneurysm Screening Study.
However, the long-term benefits in terms of mortality and cost-effectiveness are uncertain, according to Professor Simon Thompson of the Medical Research Council Unit in Cambridge, UK.
His team analysed ten years’ worth of study findings involving 67,770 men aged 65-74.
Men who were screened were half as likely to die from abdominal aortic aneurysm as those who were not. The cost per life year gained improved from about 41,000 UK pounds after four years, to 14,000 UK pounds after seven years, and 7,600 UK pounds after ten years.
On the website of the British Medical Journal, the team write: "Emphasis should be placed on achieving a high initial rate of attendance and good adherence to follow-up. Rescreening those originally screened as normal is not justified."
Nevertheless, a second study by Dr Lars Ehlers of Aarhus University, Denmark, and colleagues casts doubt over its cost-effectiveness.
They analysed previous trial results using a mathematical model, and concluded that the probability of screening being cost-effective was less than 30 per cent.
They write: "We believe our study provides a more realistic estimate of cost-effectiveness", but add: "Further research is needed on long-term quality of life outcomes and costs."
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