Key messages
- Undertaking the abdominal aortic aneurysm (AAA) screening test reduces the risk of dying from an AAA. Finding an AAA early gives the man the best chance of treatment and survival.
- The aorta is the main blood vessel that supplies blood to the body. An AAA is a swelling of the aorta in the abdomen, which left undetected, may split or rupture.
- AAA screening involves a simple ultrasound scan to measure the abdominal aorta.
- AAA screening is a free NHS test carried out in community clinics.
- Taking part in AAA screening is the man’s choice.
Background
Research evidence has shown that a high-quality screening programme for AAA can reduce deaths from ruptured aortic aneurysm by around 50% in men aged 65 – 74 years. In February 2007, the UK National Screening Committee approved the introduction of AAA screening for men aged 65 using abdominal ultrasound scanning provided:
- Invited men were given clear information about the risks of elective surgery, and
- Vascular networks were in place to treat individuals referred from screening.
The Wales Abdominal Aortic Aneurysm Programme (WAAASP) was launched in May 2013 and by 2025 aims to halve abdominal aortic aneurysm (AAA) related mortality in the eligible population through a systematic screening programme for 65-year-old men resident in Wales.
Since 1st May 2015, men who have never been for an NHS AAA screening scan and who have not been offered AAA screening because they turned 65 before it was available in Wales can contact the local screening offices to request an AAA screening scan.
Summary of activity in the reported year
Due to the impact of the pandemic on screening capacity, waiting times beyond the 65th birthday in the eligible population were longer than expected. The programme committed to ensuring that there would be no eligible men waiting beyond their 66th birthday by 31st March 2023. To achieve this, additional AAA screeners were recruited and trained and screeners worked longer hours to enable more scans to be undertaken than would be expected in any normal year.
Waiting times improved as planned by the end of March 2023. It is anticipated that fewer scans will be required in subsequent years.
Looking forward to the next screening year
In 2023/24, a new screening venue in Llanishen, north Cardiff, will be available for use. This venue will be managed by Public Health Wales and will provide a clinic facility that can be used for longer hours and, if required, 7 days a week.
As part of the drive towards sustainability, the programme will be replacing the current fleet of diesel cars with full-electric and hybrid vehicles.
Headline statistics
This report covers the time period from April 2022 to March 2023. With uptake defined as those invited in the year April 2022 to March 2023 receiving a scan by 30 June 2023.
- National uptake was 77.6%, ranging from 73.4% in Cardiff & Vale University Health Board to 82.1% in Powys Teaching Health Board.
- Uptake figures were higher in those men living in the least deprived areas (84.4%) compared to the most deprived areas (67.2%).
- Uptake of AAA screening decreased from 82.8% in 2021-22 to 77.6% in 2022-23.
- 26,068 eligible men were invited by the programme. Of these, 20,221 men attended for their first WAAASP scan and had a definitive scan result.
- Of the men who attended for their screening, 189 (0.9%) had an AAA detected by the screening programme.
- 60 men who were scanned needed a referral to the elective vascular network MDT. 83.3% of whom were referred within two working days of the scan being taken.
- 49 men had open or endovascular surgery (n.b. this is a different cohort to the men who were scanned and referred in the year). Six (12.2%) of which had their surgery completed within four or eight weeks of the referral being received, depending on the size of the AAA detected.
- 1,079 (88.1%) of surveillance scans were undertaken within standard (medium AAA on quarterly surveillance within 11 to 15 weeks of their previous successful scan, small AAA on annual surveillance within 50 to 56 weeks of their previous successful scan).
- 242 self-referred men were screened, with 12 AAA (5.0%) detected.
Full report