Result card

  • SAF6: Does the existence of harms influence tolerability or acceptability of Abdominal Aorta Aneurysm Screening?
Abdominal Aorta Aneurysm Screening
C0029
English
Guidance Resources

Does the existence of harms influence tolerability or acceptability of Abdominal Aorta Aneurysm Screening?

Authors: Iñaki Imaz, Sonia García-Pérez, Jesús González-Enríquez, Javiera Valdés, Andrés Fernández-Ramos, Carmen Bouza, Antonio Sarría-Santamera

Internal reviewers: Paolo Giorgi Rossi, Mirjana Huic, Aurora Llanos, Ingvil Sæterdal

There is scarce information on the impact of harms on acceptability or tolerability of AAA screening. However, some factors have been identified that influence AAA screening uptake. Three randomised clinical trials evaluating the efficacy of screening for AAA reported that increasing age is negatively associated with the rate of screening attendance {31-33}. Lindholt et al. {32} found from the “Viborg trial” that the age ranges 68-70 (OR 0.82, 95% CI 0.69-0.97) and 71-73 (OR 0.59, 95% CI 0.50-0.70) had significant lower attendance rates compared with the age range 65-67, when adjusting for all other predictors. This is consistent with results from the “Chichester trial” {33} and the “Western Australia Trial” {31}. Compliances in the “Chichester trial” were 80%, 76%, 74%, and 66% for ages 65, 66-70, 71-75, and 76-80 years, respectively. Moreover, compliance figures for women were 73%, 69%, 66%, 58% for the same age ranges {33}. Lindholt et al. showed that attendance rates were above average among people with chronic pulmonary and cardiovascular conditions (OR 1.40, 95% CI 1.12-1.77) compared with healthy individuals {32}. People with mobility-disabling diseases showed low rates of attendance compared with healthy individuals, although this was not statistically significant {32}.

There is also scarce information about the determinants of uptake for other screening programmes {34}. A systematic review found only one study that measured the impact of information about benefit and risks on screening uptake. The study, a randomised controlled trial that measured women’s uptake of Down’s syndrome screening, found no increase in uptake when women received additional clinical information in different forms (detailed leaflet, audiovisual) {35}.

A recent systematic review of barriers to colorectal cancer screening uptake in participants over 65 years of age found that unpleasantness, discomfort, and perceived risks associated with performing the tests were the most commonly reported barriers related to screening tests{36}. This would not apply to the AAA screening, however, because in AAA screening the perceived risk associated with the diagnostic test is low.

Additional information of factors affecting AAA screening uptake is included in the result cards RC-SOC8 and RC-SOC9.

Optional
Partially
Imaz I et al. Result Card SAF6 In: Imaz I et al. Safety In: Jefferson T, Vicari N, Frønsdal K [eds.]. Abdominal Aorta Aneurysm Screening [Core HTA], Agenzia nationale per i servizi sanitari regionali (age.na.s), Italy; 2013. [cited 28 May 2023]. Available from: http://corehta.info/ViewCover.aspx?id=106

References

  • {31}  Jamrozik K, Norman PE, Spencer CA, Parsons RW, Tuohy R, Lawrence-Brown MM et al. Screening for abdominal aortic aneurysm: lessons from a population-based study. Med J Aust 2000; 173(7):345-350.
  • {32}  Lindholt JS, Juul S, Henneberg EW, Fasting H. Is screening for abdominal aortic aneurysm acceptable to the population? Selection and recruitment to hospital-based mass screening for abdominal aortic aneurysm. J Public Health Med 1998; 20(2):211-217.
  • {33}  Scott RA, Wilson NM, Ashton HA, Kay DN. Influence of screening on the incidence of ruptured abdominal aortic aneurysm: 5-year results of a randomized controlled study. Br J Surg 1995; 82(8):1066-1070.
  • {34}  Jepson R, Clegg A, Forbes C, Lewis R, Sowden A, Kleijnen J. The determinants of screening uptake and interventions for increasing uptake: a systematic review. Health Technol Assess 2000; 4(14):i-133.
  • {35}  Michie S, Smith D, Marteau TM. Patient decision making: An evaluation of two different methods of presenting information about a screening test. British Journal of Health Psychology 1997; 2(4):317-326.
  • {36}  Guessous I, Dash C, Lapin P, Doroshenk M, Smith RA, Klabunde CN. Colorectal cancer screening barriers and facilitators in older persons. Prev Med 2010; 50(1-2):3-10.