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Universal vascular screening scheme ‘unrealistic’

By Nigel Praities

The Government’s scheme to screen for vascular disease in primary care is not targeting the right people and may be wasting NHS resources, conclude two major academic studies.

The ambitous scheme – a key plank of the Labour Party’s manifesto commitments on health – is currently being rolled out and will provide cardiovascular risk checks for everyone aged 40 to 74 years.

But the new studies appear to provide support for the Conservative Party, who have already said they would review the evidence for the programme if they get into power.

Writing in the British Medical Journal today, researchers from the University of Cambridge say the scheme may not be the best use of NHS resources.

They modelled the impact of the Government’s universal screening strategy in a population of 17,000 people aged 40 to 74 years in Norfolk, and found a similar number of CVD events could be prevented by targeting those at greatest risk using practice records. Using this strategy only 60% of the population would have to be screened, reducing the impact on resources.

The authors concluded: ‘A universal screening programme for cardiovascular disease might prevent an important number of new cardiovascular events in a population, but it may be unrealistic to implement in increasingly resource constrained health systems.’

Another study published in The Lancet last week looks at the impact of the scheme on diabetes and concludes the Government’s programme may be targeting a population too old to get the full benefit from screening.

The sophisticated computer modelling of various screening schemes in 325,000 people without diabetes suggests the most cost-effective way of screening for type 2 diabetes would be to target those aged 30-45 and repeat screening every three to five years.

The study by US and UK researchers found screening people aged 30 every three years, and those aged 45 every 3-5 years, had a cost per quality-adjusted life-year of about £6,500 – well below the £20-30,000 figure NICE requires for new treatments.

‘Our analyses suggest screening for type 2 diabetes is cost-effective when started between the ages of 30 years and 45 years, with screening repeated every 3-5 years,’ the researchers said.

Universal vascular screening scheme ‘unrealistic’