From family medical practices 15775 men and women of men). Aortic surgery was offered to the screened group aged 65-80 years were identified and randomized into two if certain criteria were met and no patient died from groups: one group was invited for ultrasonographic rupture who was fit for operation and accepted elective screening for abdominal aortic aneurysm (AAA), and the treatment. The incidence of rupture was reduced by 55 other acted as age-and sex-matched controls. Of the 7887 per cent in men in the group invited for screening, invited for screening 5394 (68.4 per cent) accepted. AAA compared with controls. The incidence of rupture in was detected in 218 (4.0 per cent overall and 7-6 per cent women was low in both groups.
Ruptured abdominal aortic aneurysm (AAA) is responsible for 1.2 per cent of all deaths in men aged 65 years and over in the UK'. In 1991 alone there were 4370 male deaths ascribed to AAA (International Classification of Diseases (ICD) code 441.3-6). One-third of patients with ruptured aneurysm die outside h ~s p i t a l ~. ~. The combination of rupture outside hospital and mortality from emergency surgery (30-50 per ~e n t ) ~-~ leads to an overall mortality rate of 80-94 per cent5.' for patients not treated electively. Elective surgery for AAA is associated with a mortality rate of less than 5 per cent in many ~n i t s ~. ~, ' and life expectancy after surgical repair is similar to that of an age-matched population'. Because ultrasonographic screening can visualize the aorta in 97.3 per cent of those screened'O, a pilot study of screening for AAA in the community was set up in 1984 and the main study with a control population was started in 1989. To the authors' knowledge no results of a screening programme for AAA with a control population have previously been published.