A study was carried out to examine the feasibility of setting up a community-based screening programme for abdominal aortic aneurysm (AAA) in men aged 65-79 years served by a district general hospital. A pilot project was run in two general practices from which 800 men were invited to undergo ultrasonography of the abdominal aorta. O f these, 628 (78.5 per cent) attended; 42 (67 per cent) were found to have an aneurysm (aortic diameter greater than 29 mm), ten (1.6 per cent) had a large aneurysm (diameter above 49 mm) and seven (1.1 per cent) received aortic grafts. O n the basis of these findings it was felt that to screen all men aged 65-79 years (n= 12 800) or aged 65-74 years (n=10300) would lead to more operations than local facilities could handle. A more practical option would be to target annually men aged 65 years, with rescreening at intervals of 5 years until age 75 years, but even this would eventually lead to an unmanageable number of operations.
Abdominal aortic aneurysm (AAA) probably affects between 2 and 4 per cent of the population'.' and as many as 8 per cent of men aged 65-79 years' ' . Most AAAs are asymptomatic but a t least 80 per cent of individuals who suffer aneurysm rupture will die".'. As AAA is easily detected by simple abdominal ultrasonography' and the results of elective surgery are generally considered a~ceptable'.'~, a case has been made for screening the at-risk population to reduce the mortality rate from this common condition6-"-" . A n umber of studies have examined various aspects of ~c r e e n i n g ~. ~. ~' 30 from which it is evident that this should be offered to men over the age of 65 years and based in the community rather than in hospital.
The aim of the present study was to determine the feasibility of instituting a screening programme from the district general hospital serving the greater part of Northumberland and staffed by a single vascular surgeon, by running a pilot project in the two general practices in the town of Alnwick. Particular reference was made to the local incidence of AAA, compliance, and the cost and workload that would be involved in running a screening programme for the whole district.