All men should have a single ultrasound at age 65 to screen for abdominal aortic aneurysm, says an editorial1 commenting on the recent MASS study.2, 3 The Multicentre Aneurysm Screening Study randomised nearly 70 000 British men, inviting half to have a screening ultrasound. Eighty per cent (27 147) accepted; 1333 aneurysms were detected and then monitored or repaired. Follow-up was for a mean of four years, in which time there were 65 aneurysm-related deaths in the invited group (including 22 men who had been invited but had not accepted) compared with 113 among controls, giving a risk reduction of 42%. 710 men needed to be screened to prevent one death. The cost-effectiveness ratio at 10 years was estimated to be £8000 per quality-adjusted life-year gained, well under the threshold for acceptability in Britain's National Health Service.
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