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Government to bring in aneurysm screening

The Government plans to introduce a national screening programme for abdominal aortic aneurysm, Pulse has learned.

By Emma Wilkinson

The National Screening Committee has agreed routine screening should be introduced for patients over the age of 65 ­ but only for men. Surgery will be recommended for aneury-sms over 5.5cm in diameter.

GPs welcomed the move, but questioned the committee's decision not to screen women ­ justified by the much higher death rate in men.

Abdominal aortic aneurysms account for 1.36 per cent of deaths in men and 0.45 per cent in women among over-65s, according to British Heart Foundation figures for England and Wales.

Dr Surendra Kumar, a GP in Widnes and member of the committee, told Pulse: 'It is going to happen in men over the age of 65 and be based on the size of the aneurysm.

'From a GP point of view, if we have information about small or medium aneurysms we can use the opportunity to give health promotion advice. It's not going to have any real workload implications.'

Sir Muir Gray, director of the National Screening Programm-es, said the focus would now be on improving services for aneurysm treatment. He said: 'We are recommending screening for aortic aneurysm, but there is an issue over lack of treatment services. It looks good but there's a lot of work needed.'

A UK study previously reported by Pulse (6 August, 2005) found general practice-based ultrasound screening for abdominal aortic aneurysm was feasible. But committee members signalled the national screening programme was likely to take place in secondary care.

Dr Terry McCormack, chair of the Primary Care Cardiovascular Society, welcomed the move, but said it could increase workload.

'If you can put an evidence-based argument forward, it's a worthwhile thing to do. It probably will increase work because we'll find more aneurysms and have to explain to patients what is going on. And patients with small or medium aneurysms will still need following up.'

Dr McCormack, a GP in Whitby, added: 'We have to be careful about excluding women from the cardiovascular picture.'

Screening committee decisions

  • Abdominal aortic aneurysm
  • Routine screening for all men over 65
  • Surgery for aneurysms over 5.5cm ­ classified as large
  • Health promotion advice for small/medium aneurysms (3.0-4.4cm and 4.5-5.4 respectively)

Diabetes

No nati

  • onal screening programme
  • Move to put targeted blood tests in future versions of QOF

Atrial fibrillation

No national screening programme

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