Final follow-up of the Multicentre Aneurysm Screening Study (MASS) randomized trial of abdominal aortic aneurysm screening.
Bottom Line: 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.Screening resulted in a reduction in all-cause mortality, and the benefit in AAA-related mortality continued to accumulate throughout follow-up.
Affiliation: Department of Public Health and Primary Care, University of Cambridge, UK. email@example.comShow MeSH
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Mentions: A total of 59 ruptured AAAs occurred after a normal first scan, of which 47 (80 per cent) were fatal. These 59 men had a mean age of 68·7 years at screening, the same as that for all the other men who had a normal first scan. There was a marked increase in the rate of these ruptured aneurysms after 8 years of follow-up. By years 12–13 the rate had increased to 8·3 per 10 000 person-years, but remained substantially lower than the overall rate of AAA rupture in the control group (Fig.2). Time since initial scan, rather than age, was the determinant of this increased risk of rupture. It was possible to retrieve 32 of the baseline scans for the 59 men with such a rupture (baseline scans were not available in one centre). Among the remeasured baseline aortic diameters, about half (18 of 32) were in the range 2·5–2·9 cm (Fig.3).
Affiliation: Department of Public Health and Primary Care, University of Cambridge, UK. firstname.lastname@example.org