Aneurysms of the abdominal aorta (AAAs) occur in 2–5% of males aged > 65 years with a history of vascular disease or smoking. However, the incidence of aneurysms of the abdominal aorta in patients with peripheral artery disease is higher (7.3–15%).
When left untreated, AAAs are prone to keep growing and weakening the arterial wall, which may eventually result in aortic dissection or rupture, which carries a mortality rate of 50–80%. In the Netherlands, approximately 700 patients die annually due to the consequences of an AAA, which includes aortic rupture as well as perioperative mortality. It has been shown that AAA screening in men aged 65–75 years who smoke can significantly reduce mortality. As a result, the Dutch National Health Council has recently commenced an investigation into the merits of a national screening programme for AAA. The writer assigned to write my essay request related to medical content is qualified to the same academic level or higher than your writing requirements.
To date, many countries are in various stages of implementing screening programmes for AAA, and in several countries without a national screening programme, screening is carried out by individual hospitals. Typically, screening will be singular (once per patient), and directed at persons at risk: males between 65 and 75 years old who smoke or have a form of atherosclerosis (peripheral artery disease or coronary artery disease) or a positive family history of AAA. Whereas screening has the obvious benefit of detection and early treatment, there are also a number of disadvantages. First, not everyone diagnosed with AAA will ultimately succumb to it, which would mean that a screening programme could lead to considerable overtreatment. Darling et al. have shown that up to 10% of post-mortem diagnostics yielded an AAA while the cause of death was unrelated.
Although this is compensated by an upper limit to the screening age, a significant portion of the aneurysms detected through screening may never become clinically relevant—especially in the case of small aneurysms (< 4 cm in diameter). In addition, there are added costs of treatment and the costs of screening itself. Contrarily, early detection of (small) aneurysms may not only lower mortality rates, but also reduce cost and disease-related morbidity as, due to early management, costly interventions for advanced aneurysms may be averted. Moreover, screening for aneurysms can trigger treatment for other types of vascular disease, such as hypertension and hypercholesterolaemia as well as to initiate cardiovascular risk management. Hire a reliable online essay writer who will create an original mediical cure information and deliver it on time.
This reduces the likelihood of progressive vascular disease in these patients, which could also significantly reduce overall cost. The costs vs. benefits of screening are quite difficult to estimate, especially since different countries employ different financial systems to manage health care. However, reducing screening costs seems a priority because it is a major factor in the decision whether or not to implement a screening programme. Usually, screening for AAA would consist of an abdominal ultrasound and an outpatient visit to inform the patient of the result. Total costs per patient are estimated at $500 in the USA and average € 222 in the Netherlands, online research conducted by our department. This difference is mainly caused by higher costs of the ultrasound examination in the USA.