Can screening programmes for abdominal aortic aneurysm safely be made more efficient by targeting them at people at the highest risk of disease?

The aorta is the largest blood vessel in your body, carrying blood from your heart down into your tummy. An abdominal aortic aneurysm happens when the wall of this vessel weakens and balloons outward. If the bulge becomes too big, it can burst, causing severe internal bleeding that is usually fatal. Finding an aneurysm early allows doctors to monitor it or repair it with planned surgery before it ever bursts.

To save lives, the NHS offers a quick, painless ultrasound scan to all men at age 65. Women rarely develop this condition, which is why the screening focuses on men. In the past, this universal screening worked well. However, smoking is the main cause of aneurysms, and as smoking rates have dropped, so have aneurysms. Today, fewer than one in every 100 men screened has a bulge. Testing so many men who are completely healthy costs millions of pounds every year and can cause unnecessary anxiety for patients.

Researchers are running a computer simulation trial—known as an 'in-silico' study—to see if there is a smarter way. In countries like the United States, screening is only offered to men who have a history of smoking. This study will look at anonymised GP and screening records in the UK to see what would happen if the NHS only invited men who have known risk factors for an aneurysm.

By comparing what actually happened to what a targeted approach would achieve, researchers want to see if high-risk screening still detects the vast majority of aneurysms. The findings could help the NHS design a more modern, cost-effective screening service that focuses on those most in need without putting low-risk men through unwanted tests.