Screening Cost for Abdominal Aortic Aneurysms: Japan-Based Estimates

Ishikawa, Susumu; Takahashi, Toru; Sato, Yasushi; Suzuki, Masao; Ohki, Satoshi T.; Oshima, Kiyohiro; Mohara, Jun; Nameki, Taro; Otani, Yoshimi; Morishita, Yasuo

doi:10.1007/s00595-004-2828-z

“…Of the 17 studies that were excluded after reviewing the full text, two did not meet the inclusion criteria as they had screened fewer than 1000 women: 795 women and 796 women. Three large studies were excluded: one consisted of a selected population (including 14 834 Chinese women with hypertension) and the other two had been carried out in 1992 and between 1992 and 1997 respectively. A recent French study provided insufficient information.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of the current prevalence of screen-detected abdominal aortic aneurysm in women

Ulug

¹

,

Powell

²

,

Sweeting

³

et al. 2016

British Journal of Surgery

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Background: Although women represent an increasing proportion of those presenting with abdominal aortic aneurysm (AAA) rupture, the current prevalence of AAA in women is unknown. The contemporary population prevalence of screen-detected AAA in women was investigated by both age and smoking status.Methods: A systematic review was undertaken of studies screening for AAA, including over 1000 women, aged at least 60 years, done since the year 2000. Studies were identified by searching MEDLINE, Embase and CENTRAL databases until 13 January 2016. Study quality was assessed using the Newcastle-Ottawa scoring system.Results: Eight studies were identified, including only three based on population registers. The largest studies were based on self-purchase of screening. Altogether 1 537 633 women were screened. Overall AAA prevalence rates were very heterogeneous, ranging from 0⋅37 to 1⋅53 per cent: pooled prevalence 0⋅74 (95 per cent c.i. 0⋅53 to 1⋅03) per cent. The pooled prevalence increased with both age (more than 1 per cent for women aged over 70 years) and smoking (more than 1 per cent for ever smokers and over 2 per cent in current smokers). Conclusion:The current population prevalence of screen-detected AAA in older women is subject to wide demographic variation. However, in ever smokers and those over 70 years of age, the prevalence is over 1 per cent.

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“…Three large studies were excluded: one 33 consisted of a selected population (including 14 834 Chinese women with hypertension) and the other two 34,35 had been carried out in 1992 and between 1992 and 1997 respectively. A recent French study 36 provided insufficient information.…”

Section: Resultsmentioning

confidence: 99%

Meta-Analysis of the Current Prevalence of Screen-Detected Abdominal Aortic Aneurysm in Women

Ulug¹,

Powell²,

Sweeting³

2016

Journal of Vascular Surgery

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Background: Although women represent an increasing proportion of those presenting with abdominal aortic aneurysm (AAA) rupture, the current prevalence of AAA in women is unknown. The contemporary population prevalence of screen-detected AAA in women was investigated by both age and smoking status.Methods: A systematic review was undertaken of studies screening for AAA, including over 1000 women, aged at least 60 years, done since the year 2000. Studies were identified by searching MEDLINE, Embase and CENTRAL databases until 13 January 2016. Study quality was assessed using the Newcastle-Ottawa scoring system.Results: Eight studies were identified, including only three based on population registers. The largest studies were based on self-purchase of screening. Altogether 1 537 633 women were screened. Overall AAA prevalence rates were very heterogeneous, ranging from 0⋅37 to 1⋅53 per cent: pooled prevalence 0⋅74 (95 per cent c.i. 0⋅53 to 1⋅03) per cent. The pooled prevalence increased with both age (more than 1 per cent for women aged over 70 years) and smoking (more than 1 per cent for ever smokers and over 2 per cent in current smokers). Conclusion:The current population prevalence of screen-detected AAA in older women is subject to wide demographic variation. However, in ever smokers and those over 70 years of age, the prevalence is over 1 per cent.

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“…Lindholt et al [ 10 ] estimated ICER to be GBP 6 090 per gained life-year without long-term cost and discounting. The three other studies that used patient-level data (from local cohort studies or case-control studies) estimated ICER to be in the same order of magnitude, and suggested that screening may be cost-effective [ 11 - 13 ].…”

Section: Resultsmentioning

confidence: 99%

Is population screening for abdominal aortic aneurysm cost-effective?

Ehlers

¹

,

Sørensen

²

,

Jensen³

et al. 2008

BMC Cardiovasc Disord

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BackgroundRuptured 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.MethodsWe 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.ResultsThe 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.ConclusionFurther analyses of cost-effectiveness of AAA screening are recommended.

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Screening Cost for Abdominal Aortic Aneurysms: Japan-Based Estimates

Abstract: Screening for AAA using ultrasound is useful not only for the early detection of AAA but also for a reduction in the overall medical cost.

Cited by 10 publications

References 18 publications

Meta-analysis of the current prevalence of screen-detected abdominal aortic aneurysm in women

Meta-analysis of the current prevalence of screen-detected abdominal aortic aneurysm in women

Meta-Analysis of the Current Prevalence of Screen-Detected Abdominal Aortic Aneurysm in Women

Is population screening for abdominal aortic aneurysm cost-effective?

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