Abdominal aortic aneurysm screening program in Poland

Abstract

BackgroundScreening for abdominal aortic aneurysms (AAA) is currently recommended by several vascular societies. In countries where it has been introduced the prevalence of AAAs differed greatly and was mainly related to cigarette smoking. The screening program also had an enormous impact on the decrease of AAA ruptures and reduced mortality rate. These facts have led to the introduction of the first screening program for AAAs in Poland.ObjectiveThe aim of the study was to determine the prevalence of AAAs among men aged 60 years and older undergoing ultrasound examination of the abdominal aorta.Material and methodsA single ultrasonography of the abdomen was performed to assess the aorta from the renal arteries to the bifurcation and the diameter of the aorta was measured at its widest point. The cut-off value for determining an aortic aneurysm was set at a diameter of ≥ 30 mm. All ultrasonography measurements were performed by physicians in outpatient departments throughout the Kuyavian-Pomeranian Province. Additionally, each subject had to fill out a questionnaire with demographic data, smoking habits, existing comorbidities and familial occurrence of AAAs. The study was conducted from October 2009 to November 2011.ResultsThe abdominal aorta ultrasound examinations were carried out in 1556 men aged 60 years and older. The prevalence of AAA in the study population was 6.0 % (94 out of 1556). The average age of the men was 69 years (SD 6 years, range 60–92 years). In the study population 55 % of the men smoked or had smoked and 3 % were aware of the presence of AAAs in family members. There were three risk factors significantly associated with the presence of AAAs: age (p < 0.05), smoking (72.3 % vs 53.9 %, p = 0.004) and family history of AAAs (9.6 % vs 2.7 %, p = 0.017).ConclusionThe prevalence of AAAs among men in Poland is higher than in other European countries and the USA. The screening program for AAAs is an easy and reliable method for detecting early stages of the disease and risk factors which are the driving forces for the development of AAAs.

Prevalence and risk factors of abdominal aortic aneurysm among over 65 years old population in Lublin, Poland

“…However, in this study, the prevalence of smoking cigarettes -one of the main risk factor of AAA -was also very high (55%). The distribution of the detected AAAs according to the maximum diameter was similar to the one observed in our study [23].…”

“…A similar study, held in Poland from 2009 to 2011 in the Kuyavian-Pomeranian Province by Jawien et al [23] showed that the prevalence of AAA in the population of men aged 60 years and older was 6.0%, which is higher than in our study. However, in this study, the prevalence of smoking cigarettes -one of the main risk factor of AAA -was also very high (55%).…”

The prevalence of abdominal aortic aneurysms in the rural/urban population in central Poland — Gniewkowo Aortic Study

“…According to these guidelines, mortality from AAA can be reduced by almost a half within four years, mostly by reducing the incidence of ruptured aneurysms due to population screening for AAA of older men, in areas where the prevalence is 4% or more (level of evidence 1a, strength of recommendation A). In two studies conducted in the Kuyavian-Pomeranian voivodship in 2012 and 2013, AAA during screening among men aged 65 years and more was found in 5.4% of patients [17,18]. The data obtained in this study by the authors showed that the prevalence of AAA is a bit higher than the results obtained in the 1990s.…”

Risk Factors for Abdominal Aortic Aneurysm in Population-Based Studies: A Systematic Review and Meta-Analysis

“…In those countries where screening campaigns are active, the mortality rate is in constant decline. The introduction of AAA screening saves lives, prevents the rupture risk, coincides with a falling prevalence of the disease, reduces the incidence of aneurysm rupture, decreases the mortality [1,9,18,34,36,40,57,66,67].…”

“…Also hypertension, CAD and family history of AAA are risk factors for AAA, but, it is important to underline family history should be considered with caution because the confidence interval is wide enough, therefore effect size pooled could be influenced. As regard to the role of hypertension as potential risk factor for AAA same authors [8,36,43,59,68] are in disagreement. Alcorn et al [56] suggest that individuals with hypertension are more likely to be evaluated clinically for the identification of AAA and this leads to a greater number of AAA diagnoses.…”