Abdominal aortic aneurysm
(AAA) screening is a way of checking if there is a bulge or
swelling in the aorta, the main blood vessel that runs from your
heart down through your tummy. This
bulge or swelling is called an abdominal aortic aneurysm, or AAA. It can
be serious if it is not spotted early on because it could get bigger and
eventually burst (rupture).
Who is screened for AAA
In
England, screening for AAA is offered to men during the year they turn 65. Men
aged 65 or over are most at risk of AAAs. Screening can help spot a
swelling in the aorta early on when it can be treated.
Screening
for AAA isn't routinely offered to:
- women
- men under 65
- people who've already been treated for an AAA
This is
because the risk of an AAA is much smaller in these groups. You can
ask for a scan to check for an AAA if you think you might need one but haven't
been offered a screening test.
How to get screened for AAA
If you are
a man and you are registered with a GP, you will get a screening invitation
in the post when you are 64 or soon after your 65th birthday. You can then
arrange an appointment that suits you.
If you are
a man over 65 and you have not been screened before, you can ask for a test
by contacting your local AAA screening service directly.
If you are
a woman or man under 65 and you think you might have a higher risk of AAA – for
example, because a close family member has had one – talk to your GP about the
possibility of having a scan to check for an AAA. If your
GP thinks you might benefit from having a scan, this will usually be done when
you're five years younger than the age at which your relative was found to have
an AAA.
Benefits of AAA screening
An AAA
will often cause few or no obvious symptoms, but if it is left to get bigger
it could burst and cause life-threatening bleeding inside your tummy. About 8
in every 10 people who have a burst AAA die before they get to hospital or
don't survive emergency surgery to repair it.
Screening
can pick up an AAA before it bursts. If an AAA is found, you can then choose to
have regular scans to monitor it or surgery to stop it bursting. The
screening test is very quick, painless and reliable. Research suggests it can
halve the risk of dying from an AAA.
Deciding to be screened
It is up
to you to decide if you want to be screened for AAA. While there are clear
benefits of screening, you should also consider the possible risks. There is
no risk from the screening test itself, but there is a risk of:
- anxiety from being told you have a life-threatening condition
- serious complications of surgery carried out to treat an AAA
You will get
a leaflet with your screening invitation to help you make a decision. You
can also read a decision aid leaflet online. Call your
local screening service and ask to be removed from its list if you don't
want to be screened.
What happens during AAA screening
Screening
for AAA involves a quick and painless ultrasound scan of your tummy. This is
similar to the scan pregnant women have to check on their baby. When you
arrive for your appointment, a screening technician will check your details,
explain the scan and ask if you have any questions.
For the
scan:
- you lie down on a table and lift up or unbutton your top (you do not need to undress)
- the technician rubs a clear gel on your tummy and moves a small handheld scanner over your skin – pictures from the scanner are shown on a monitor and the technician will measure how wide your aorta is
- the gel is wiped away and you pull down or button up your top
- the technician tells you the result straight away
The whole
test usually takes about 10-15 minutes.
Sometimes
the technician might not be able to see your aorta clearly. This
is not anything to worry about. If this happens, you will be asked to have another
scan, usually on a different day.
Schematic diagram showing the possible management/ treatment pathways following screening for Abdominal Aortic Aneurysm (AAA).
Results of AAA screening
You will be
told your result at the end of the test. If any problem is found, you will
also be a sent letter confirming the result and letting you know what happens
next.
There are
four possible screening results.
1) Normal
A normal
result means your aorta is not swollen (it is less than 3cm across) and you
do not have an AAA. More than 98% of men screened have a normal
result. If your
result is normal, you won't need any further scans or treatment because an
AAA grows slowly and the chances of you developing one after 65 are very small.
2) Small AAA
If you
have a small AAA, this means your aorta measures 3cm to 4.4cm across.
Just over 1% of men screened have a small AAA. You won't
need any treatment at this stage as the chance of the AAA bursting is
small. You will be invited back for a scan every year to check its size. Treatment
will usually only be needed if it becomes a large AAA.
You will
also be given advice on how you can stop an AAA getting bigger,
such as stopping smoking, eating healthily and exercising regularly.
3) Medium AAA
If you
have a medium AAA, this means your aorta measures 4.5cm to 5.4cm
across. About 0.5% of men screened have a medium AAA. You won't
need any treatment at this stage as the chance of the AAA bursting is
small. You will be invited back for a scan every three months to check its size.
Treatment will usually only be needed if it becomes a large AAA.
You will
also be given advice on how you can stop an AAA getting bigger,
such as stopping smoking, eating healthily and exercising regularly.
4) Large AAA
If you
have a large AAA, this means your aorta measures 5.5cm or more across.
About 0.1% of men screened have a large AAA. As
large AAAs are at the highest risk of bursting if left untreated, you will
be referred to a specialist surgeon within two weeks to talk about your
treatment options.
Most men
with a large AAA are advised to have surgery to stop it getting bigger or
bursting. While
surgery carries a risk of serious complications, this is generally smaller than
the risk of not treating a large AAA.
More information about AAA screening
For more
information, the AAA Screening Programme has guides about:
The
GOV.UK website also has AAA screening leaflets in other languages.
Source: NHS Choices
