Population-based screening for abdominal aortic aneurysm (AAA)

An abdominal aortic aneurysm (AAA) is a dilatation in the main artery in the abdomen, which, if it bursts, often results in death. Before that stage, an AAA often goes unnoticed but can be detected easily with an ultrasound scan and operated to prevent rupture.
In some countries, AAA’s are detected through systematic screening of all men at 65 years of age. In the Netherlands AAA’s are diagnosed and treated within regular patient care. The Dutch approach seems to be effective: more AAA’s (per capita) are detected and treated here than in countries where population-based screening has been set up. Hence, the Health Council expects the added value of a population-based screening programme in the Netherlands to be limited. Too limited in any case to compensate for the considerable disadvantages of such a programme. Screening would lead to a higher number of preventive AAA-operations, which are still risky and may lead to severe complications and mortality. The Health Council therefore advises against population-based screening for AAA in the Netherlands and instead recommends exploring whether some steps within the current, less intrusive approach of AAA-detection in regular care, could be improved.