In-silico trials of targeted screening for abdominal aortic aneurysm using linked healthcare data

Can the efficiency of the NHS Abdominal Aortic Aneurysm Screening Programme be improved whilst maintaining publicly acceptable levels of disease detection in an ethically acceptable manner?

To reduce the number of people dying from ruptured abdominal aortic aneurysms (AAA) the NHS offers a screening service to men at the age of 65 (women rarely get AAA).

About 280,000 men are invited for screening each year. One in every 100 men screened are found to have an AAA.

This screening programme costs the NHS about £7.75 million per year, much of which spent on screening the 99% of men who do not have AAAs. The screening invitation and testing process may also lead to unnecessary worry for some men who are found not to have an AAA. 

As AAAs are becoming less common, the screening cost per person is becoming higher and eventually the NHS will not be able to justify spending money on AAA screening. 

This research project aims to find out whether a new way of delivering the screening programme can be designed that is both more economical for the NHS and acceptable to the public.

To do this, the project team will analyse combined results from the NHS AAA Screening Programme from 2013-2021 and (anonymised) general practice records of around one fifth of the men invited for screening.

The team aims to work out what would have happened if only men with known risk factors for AAA had been invited for AAA screening, and whether there are other details in general practice records that can be used to identify men at high, or low, risk of AAA.

The information will be used to see if AAA screening can be targeted at groups of men who are at a high risk of having an AAA and, if so, whether such a targeted screening programme will still identify the majority of men with AAAs.  

The ethics and acceptability of targeted screening will be explored with members of the public. The team will also consult extensively with the public to determine what is important to those who might be affected by changes to the AAA screening programme.

The project team will use its established links with UK public health bodies to ensure the results of this research are acted upon, and make them available to the public and to researchers. 

Project website