Abdominal Aortic Aneurysm Screening Reduces All-Cause Mortality: Make Screening Great Again

We performed an updated meta-analysis of the longest (≥13 years) follow-up results from 4 randomized controlled trials of abdominal aortic aneurysm (AAA) screening in ≥64-year-old men. Invitation to screening reduced all-cause mortality significantly according to time-to-event data (hazard ratio: 0.98; 95% confidence interval [CI]: 0.96-0.99; P = .003) despite no reduction according to dichotomous data (odds ratio [OR]: 0.99; 95% CI: 0.96-1.01; P = .23). Invitation to screening reduced AAA-related mortality significantly (OR: 0.66; 95% CI: 0.47-0.93; P = .02) but did not reduce non-AAA-related mortality (OR: 1.00; 95% CI: 0.98-1.02; P = .96). All-cause, AAA-related, and non-AAA-related mortalities were significantly lower in attenders than in nonattenders, in noninvitees, or in both. All-cause (OR: 1.41; 95% CI: 1.23-1.63; P < .00001) and non-AAA-related mortalities (OR: 1.39; 95% CI: 1.18-1.64; P < .0001) were significantly higher in nonattenders than in noninvitees. In conclusion, invitation to AAA screening in ≥64-year-old men reduced both all-cause and AAA-related mortalities significantly. All-cause and non-AAA-related mortalities were significantly higher in nonattenders than in noninvitees, though both did not undergo screening.