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Title: | Final follow-up of the Multicentre Aneurysm Screening Study (MASS) randomized trial of abdominal aortic aneurysm screening |
Authors: | Thompson, SG Ashton, HA Gao, L Buxton, MJ Scott, RAP |
Keywords: | Abdominal aortic aneurysm (AAA);UK Multicentre Aneurysm Screening Study (MASS);Long-term effects |
Issue Date: | 2012 |
Publisher: | Wiley Online Library |
Citation: | British Journal of Surgery, 2012 |
Abstract: | Background: The long-term effects of abdominal aortic aneurysm (AAA) screening were investigated in extended follow-up from the UK Multicentre Aneurysm Screening Study (MASS) randomized trial. Methods: A population-based sample ofmen aged 65–74 years were randomized individually to invitation to ultrasound screening (invited group) or to a control group not offered screening. Patients with an AAA (3·0 cm or larger) detected at screening underwent surveillance and were offered surgery after predefined criteria had been met. Cause-specific mortality data were analysed using Cox regression. Results: Some 67 770 men were enrolled in the study. Over 13 years, there were 224 AAA-related deaths in the invited group and 381 in the control group, a 42 (95 per cent confidence interval 31 to 51) per cent reduction. There was no evidence of effect on other causes of death, but there was an overall reduction in all-cause mortality of 3 (1 to 5) per cent. The degree of benefit seen in earlier years of follow-up was slightly diminished by the occurrence of AAA ruptures in those with an aorta originally screened normal. About half of these ruptures had a baseline aortic diameter in the range 2·5–2·9 cm. It was estimated that 216 men need to be invited to screening to save one death over the next 13 years. Conclusion: Screening resulted in a reduction in all-cause mortality, and the benefit in AAA-related mortality continued to accumulate throughout follow-up. Registration number: ISRCTN37381646 (http://www.controlled-trials.com). |
URI: | http://onlinelibrary.wiley.com/doi/10.1002/bjs.8897/abstract http://bura.brunel.ac.uk/handle/2438/9891 |
DOI: | http://dx.doi.org/10.1002/bjs.8897 |
ISSN: | 1365-2168 |
Appears in Collections: | Health Economics Research Group (HERG) |
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