Abstract
Abdominal aortic aneurysm (AAA) is a potentially fatal condition predominantly affecting older adult men (60 years or over). Based on evidence, preventative health-care guidelines recommend screening older males for AAA using ultrasound. In attempts to reduce AAA mortality among men, screening has been utilized for early detection in some Western countries including the UK and Sweden. The current scoping review includes 19 empirical studies focusing on AAA screening in men. The findings from these studies highlight benefits and potential harms of male AAA screening. The benefits of AAA screening for men include decreased incidence of AAA rupture, decreased AAA mortality, increased effectiveness of elective AAA repair surgery, and cost-effectiveness. The potential harms of AAA screening included lack of AAA mortality reduction, negative impacts on quality of life, and inconsistent screening eligibility criteria being applied by primary care practitioners. The current scoping review findings are discussed to suggest changes to AAA screening guidelines and improve policy and practice.
Highlights
Aneurysms are defined as an irreversible and focal dilatation of a blood vessel that exceeds 1.5 times the normal vessel diameter (Carino et al, 2018)
The current study was directed by the following research question: What are the benefits and potential harms of screening older adult men for abdominal aortic aneurysm (AAA)? Arksey and O’Malley’s (2005) scoping review framework neatly matched the aim of the current study wherein summarizing and disseminating key research findings and identifying research gaps were central to synthesizing understandings about AAA screening in men
The findings drawn from the analyses are organized under two descriptive labels: (1) benefits of AAA screening for men, and (2) potential harms of AAA screening for men
Summary
Aneurysms are defined as an irreversible and focal dilatation of a blood vessel that exceeds 1.5 times the normal vessel diameter (Carino et al, 2018). Risk factors for AAA development include male sex, older age, tobacco use, family history, European ancestry, hypertension, hypercholesteremia, and history of other large vessel aneurysms (Benson et al, 2018; Carino et al, 2018; Cornuz et al, 2004; Wanhainen et al, 2020). The leading options for AAA repair are open surgical repair and endovascular aneurysm repair (EVAR) (Benson et al, 2018; Carino et al, 2018) Both surgical methods are used for the elective repair of large AAAs and the emergent repair of rAAAs (Keisler & Carter, 2015)
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