Result card

  • ORG4: What kind of co-operation and communication of activities does AAA Screening require?

What kind of co-operation and communication of activities does AAA Screening require?

Authors: Janek Saluse, Kristi Liiv, Raul-Allan Kiivet

Internal reviewers: Grace Jennings, Scott Goulden

UK recommendations for AAA screening organisation {2} were used as an example of informational needs for systematic population-based AAA screening.

Men should be able to make a genuinely informed choice based on an understanding why they are attending for screening, the risks involved and associated with a positive result, and what happens to their records after they are screened {2}.

Implementing a screening programme will require three different kinds of information:

1) For publicity to inform the target population and their relevant others about the screening programme.

The national programme director will be responsible for publicity in relation to the programme and central written resources.

Nationally developed and approved information is available to all local AAA screening programmes. It is the responsibility of the local programme to ensure that information is available to all men and that literature is displayed in appropriate locations.

The invitation leaflet is designed to ensure that men are told what screening can and cannot achieve. This, along with the invitation letter, addresses the need to inform subjects about the use made of personal information for audit.

Posters are available and provided by the national programme centre for display in GP surgeries, other primary care facilities and other suitable public locations identified locally. Information sheets for GPs and other healthcare professionals are also available and provided by the national programme centre.

A website for patients and professionals is administered by the national programme centre {2}.

2) For men participating in the programme that do not need follow-up or operation; men needing follow-up; and men needing operation.

There should be separate leaflets for men who enter the surveillance programme and for those identified with an AAA of 5.5 cm or greater setting out the benefits and risks of AAA surgery. Informed consent must contain information about the risks, benefits and alternatives of treatment {2}. In an ultrasound study most surgeons agreed that mortality should be clearly stated to patients eligible for operation. There were substantial variations in opinion across surgeons regarding what risks should be included and which complication rates to quote {7}. It is agreed that numerical presentation of risks is most suitable for patients, depending on the patient’s preference for being more or less involved in the decision making process {8}.

3) For organisational aspects of screening programme (for staff).

The programme’s internal communication plan is specified in the job descriptions of staff (using IT solutions, mail, telephone, meetings) {2}.

Co-operation, outside the screening programme, needs to be arranged between screening programme staff and surgeons to whom patients with aneurysms larger than 5.5 cm are referred. It is ethically and medically important that all subjects have both a consultation with a surgeon and the surgery itself (when needed) within a reasonable time period. It is also crucial to evaluate the results of the screening programme – by analysing the number of elective procedures and the mortality of those screened and treated. All this needs a working co-operation between screening programme staff and surgeons {2}.

Saluse J et al. Result Card ORG4 In: Saluse J et al. Organisational aspects In: Jefferson T, Vicari N, Frønsdal K [eds.]. Abdominal Aorta Aneurysm Screening [Core HTA], Agenzia nationale per i servizi sanitari regionali (, Italy; 2013. [cited 28 May 2023]. Available from: