Screening for an abdominal aortic aneurysm is extremely important. Doctors refer to this as AAA (pronounced "triple-A") screening. It looks for any weakness in the aorta, the biggest blood vessel in your body. This runs from your heart to the centre of your chest and your abdomen, delivering oxygenated blood to your tissues and organs. Any weakness (aneurysm) can lead to rupture, which causes a life-threatening bleed into your tummy within seconds.
Screening is aimed at detecting disease in those most at risk. Men are at higher risk of developing an AAA, and this increases with age, so men aged 65 and over are invited for a test. You’ll receive your invite automatically by post from the local health authority – they'll use your age and the contact details held in your doctor's records. Owing to the risk profile, this screening is not offered routinely to women, men under 65, or if you’ve already received treatment for an AAA.
The aim is to pick up an AAA early. You don’t really develop symptoms, so the best way is with an ultrasound scan. You will lie on a trolley while an ultrasound technician or doctor uses a handheld probe with gel to scan over the skin of your tummy. They are looking for any bulging or swelling in the wall of the aorta, which they can then measure.
It takes about 10 to 15 minutes, and you’re told the results there and then. There aren’t really any risks to this screening test, but it can cause anxiety, given the implications of finding a potentially life-threatening condition.
This is a one-off test – if no swelling is found, you won’t have any follow-up. If they do find something, they’ll measure it and let this guide further management. A small AAA carries a small chance of rupture, so this goes under surveillance and you’ll be invited back every year for them to measure it. A medium-sized AAA will be checked every 3 months.
Treatment is reserved for a large AAA, and you’ll be referred to a vascular team who can talk you through the surgical options in this case.
You can lower your risk of developing an AAA and of it getting any larger by looking at your lifestyle. Smoking is a risk factor, so you’re advised to stop. You’re encouraged to lose weight if you are obese, to following a healthy balanced diet, and to exercise regularly, all in a bid to keep your blood vessels in good working order.
Do what you can to control any conditions that affect the arteries, such as diabetes, high blood pressure and raised cholesterol.
The World Health Organisation has defined the criteria to make a screening test worth rolling out, and this forms the basis for any UK screening programmes. A screening test is worthwhile if:
it tests for an important health condition
there's a suitable test or examination, and this is highly accurate at picking up disease
the test is acceptable to the targeted population – by this, we mean that it’s convenient, not too invasive or uncomfortable, and without considerable risk
the condition is detectable early on – before symptoms might prompt you to visit the doctor when it becomes an obvious disease
there's an accepted treatment for the condition
The AAA screening has passed these criteria.
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