The burden of AAA arises from the risk of AAA rupture and from harm that may arise from preventive actions against the risk of rupture. From a public health perspective the benefits and harms from organised preventive actions (and their consequences) must be compared with the benefits and harms from care that is not organised in the form of a public health programme (individual care, opportunistic screening).

The benefit and harm that may be introduced by a screening programme depend on the prevalence of the disease (prevalence of AAAs, ruptured AAAs and deaths from ruptured AAAs), and on the effectiveness of the screening and of the preventive interventions. Information about AAA prevalence is given in this result card, whereas information about screening programme characteristics (sensitivity, specificity) is given in the Description and technical characteristics of the technology (TEC) domain and information about the effectiveness of preventive interventions (e.g. surgery, behavioural change) is in the Effectiveness of the technology (EFF) domain.

The public health burden of AAA is increasing in developed countries because of its increasing prevalence in many populations {10}. This increase in prevalence can be explained, in part, by the increase in the number of people in the age groups at higher risk of developing AAA. In European countries {Table} the number of people aged 60-79 has increased from 14% in 1990 to 17% in 2010.

Mortality in different age groups

The mortality due to ruptured AAAs varies in different age groups as follows {5}:

Prevalence in high risk groups

The following table shows AAA prevalence in high risk age groups among five British populations (with definitions of AAA by diameter around 3 cm):

Overall, the prevalence of AAA in these ‘high risk’ age groups is around 4%-8 %.{5}

Ruptured AAAs have a high risk of death (see CUR6). If the patient survives the emergency surgery, they still have a higher mortality risk.