Population Ultrasound Screening for Abdominal Aortic Aneurysms

Abdominal aortic aneurysm (AAA) is a serious vascular disease which may lead to sudden death. Approximately 20% of affected persons have an aneurysm greater than 5 cm requiring immediate surgical treatment. This intervention is effective, but its associated mortality is significant, varying between 5% and 10% according to the health-care setting. Patients who have a smaller aneurysm receive periodic follow-up and optimized medical treatment until the risk of rupture justifies a surgical intervention. A risk of sudden death from ruptured aortic aneurysms is always present for these patients.

AETMIS has assessed the suitability and feasibility of a screening program for abdominal aortic aneurysms by ultrasound in Québec by applying the matrix of recognized criteria for screening programs and studied the findings of the scientific literature as well as the organizational, economic, legal and ethical issues associated with implementation of such a program.

AETMIS has concluded that the necessary conditions for successful implementation of such a screening program are not currently met in Québec. However, the current state of epidemiological and organizational conditions in Québec, although not favourable to the immediate implementation of such a program, suggests a number of ways to improve the situation. The MSSS and professional bodies directly concerned are invited to work together to establish priorities and a plan of action for improving the organizational and clinical management of patients who have an AAA or present the associated risk factors and properly gauging the true potential of a systematic screening program.