Should Asian Men be Included in Abdominal Aortic Aneurysm Screening Programmes?

M.K Salem,R.D Sayers,S Rafelt,C.P Nelson,A Nasim,H.S Rayt,G Hussey,A.R Naylor

doi:10.1016/j.ejvs.2009.07.012

M.K Salem, R.D Sayers + Show 6 more

Open Access

https://doi.org/10.1016/j.ejvs.2009.07.012

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Abstract

A national AAA screening programme for men aged 65 is shortly to be implemented in England. Trials that have provided evidence for this screening programme have not included information on ethnicity. Hence their findings may not be applicable to ethnically diverse populations. This study retrospectively looked at the prevalence of AAA in men aged 65, from different ethnic backgrounds in our city's current screening programme.19014 men (Caucasians n=18,431, Asian n=446, others n=137) were screened. Prevalence was 4.69% (4.39-5% 95% CI), and 0.45% (0.054-1.161% 95% CI) in Caucasians and Asians respectively (Fisher's exact test: P<0.0001). Prevalence of AAAs in men aged 65 of Asian origin appears to be low and so increases uncertainty about cost-effectiveness of screening Asian men.

Highlights

An AAA screening program for men aged 65 is to be introduced this year in England
The prevalence in Asian men is significantly lower and this is consistent with the observations of other authors[4,5] who reported a variation in prevalence of peripheral arterial disease in different ethnic groups
A lower rate of participation by Asian men in the screening programme could account for the difference in prevalence seen, and one major limitation of our partpopulation screening programme is that attendance rates were not recorded

Summary

Introduction

An AAA screening program for men aged 65 is to be introduced this year in England. Evidence of benefit for AAA screening in men has come from 4 randomised trials, showing a highly significant reduction in aneurysm-related mortality in the screened population.[1] The above trials provided no data on race or ethnicity of the participants and their findings may not be applicable to ethnically diverse populations. Our city has a higher than average population of Asians from the Indian sub-continent. The aim of this study was to establish whether the prevalence of AAA amongst Asian men is different to Caucasian men in our screening programme. We have been undertaking AAA screening in participating general practices in Leicester since 1993.

Asian Men and Aortic Aneurysm Screening?

Findings

Discussion