Refinements in abdominal aortic aneurysm screening; a new screening tool and incorporation of body surface area correction

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Abdominal aortic aneurysm (AAA) is an age-associated degenerative vascular disorder ranked as the 10th most common cause of death in male patients above the age of 55 years. While AAA-related mortality rates have been reported to be in a decline globally, in part likely due to reduced smoking rates, this condition remains a significant burden on our community and health system, particularly for Māori New Zealanders. While countries such as the United Kingdom have relatively recently introduced national screening programmes, there remains debate as to who should be screened. The question as to whether countries with aging populations, such as New Zealand and Australia, should introduce AAA screening programmes remains highly topical as AAA still represents a significant cause of preventable death. This talk will discuss our current understanding of AAA prevalence in both men and women and also compare this within specific sub-groups, such as those with elevated cardiovascular disease (CVD) risk factor profiles or high AAA-specific risk scores. Two key observations of note were (1) significantly increased rates of AAA in those with elevated CVD risk and (2) an almost doubling of AAA prevalence in women when sex-specific AAA size thresholds were applied to screening. Based on a large series of locally-based pilot studies the Aotearoa New Zealand AAA Screening Working Group has developed a strategy which we believe will deliver a sex and ethnicity equitable AAA screening programme that also contributes to (broad) cardiovascular risk prediction.