A multidisciplinary team of vascular doctors, data scientists and researchers in humanities and social sciences are working to determine if targeting screening for abdominal aortic aneurysm (AAA) at smokers and ex-smokers would be cost-effective and ethically acceptable for patients and the public.
The NIHR Leicester BRC study led by the University of Leicester’s Professor of Vascular Surgery, Matthew Bown, has been funded by the National Institute of Health Research within its programme, ‘Health and Social Care Delivery Research’.
This is an ambitious study that will analyse health data from more than two million men invited for AAA screening between 2013 and 2021.
AAA is a significant cause of mortality and morbidity. AAA is a swelling in the main vessel in the body, the aorta, which mainly affects men.
In England and Wales each year AAA rupture causes over 4,000 deaths and over 8,000 patients undergo surgical AAA repair to prevent rupture. The NHS invites men at the age of 65, approximately 280,000 each year, for a one-off ultrasound scan to screen for AAA. As smoking, the main risk factor for AAA, is decreasing among the population, much of the cost of this programme is spent on screening men who do not have an AAA, and the programme can disappear in the future.
There is an alternative way to screen men for AAA that is more cost-effective: targeting AAA screening at smokers or former smokers only. It is not clear, however, whether a targeted screening programme would miss many men who never smoked but have an AAA.
Professor Bown and his team will link data from the NHS AAA Screening Programme and general practices to work out what would have happened if only men with known risk factors for AAA had been invited for screening.
Professor Bown said:
“We expect this study to have a direct and significant impact on NHS, UK and worldwide AAA screening policies.”
Dr Maria Gonzalez Aguado, a social scientist leading this component of the study, explains that this is an excellent opportunity for men to be involved in research that affects them and help shape the future of AAA screening in the NHS.
The research team want to find out if current and future users of the NHS AAA Screening Programme and members of the public would consider these changes ethical and acceptable. They are currently recruiting men and members of the public for two focus groups or interviews. Men who have been invited for AAA screening, or will be in the next five years (men aged 59-64), and members of the public without a personal experience of AAA or AAA screening, but keen on participating in research, living in, or near, Leicester can take part in this study. AAA screening uptake is lower within less privileged areas, the team are particularly keen on talking with men living in these areas.
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