@article {Chane027291, author = {Wing Cheuk Chan and Dean Papaconstantinou and Doone Winnard and Gary Jackson}, title = {Retrospective review of abdominal aortic aneurysm deaths in New Zealand: what proportion of deaths is potentially preventable by a screening programme in the contemporary setting?}, volume = {9}, number = {7}, elocation-id = {e027291}, year = {2019}, doi = {10.1136/bmjopen-2018-027291}, publisher = {British Medical Journal Publishing Group}, abstract = {Objectives To describe the proportions of people dying from abdominal aortic aneurysm (AAA) who might have benefited from a formal screening programme for AAA.Design Retrospective cross-sectional review of deaths.Setting and study populations All AAA deaths registered in New Zealand from 2010 to 2014 in the absence of a national AAA screening programme.Main outcome measures Known history of AAA prior to the acute event leading to AAA death, prognosis limiting comorbidities, history of prior abdominal imaging and a validated multimorbidity measure (M3-index scores).Results 1094 AAA deaths were registered in the 5 years between 2010 and 2014 in New Zealand. Prior to the acute AAA event resulting in death, 31.3\% of the cohort had a known AAA diagnosis, and 10.9\% had a previous AAA procedure. On average, the AAA diagnosis was known 3.7 years prior to death. At least 77\% of the people dying from AAA also had one or more other prognosis limiting diagnosis. The hazard of 1-year mortality associated with the non-AAA related comorbidities for the AAA cohort aged 65 or above were 1.5{\textendash}2.6 times higher than to the age matched general population based on M3-index scores. In 2014, overall AAA deaths accounted for only 0.7\% of total deaths, and 1.0\% of deaths among men aged 65 or above in New Zealand. At most, 20\% of people dying from AAA in New Zealand between 2010 and 2014 might have had the potential to derive full benefit from a screening programme. About 51\% of cases would have derived no or very limited benefit from a screening programme.Conclusion Falling AAA mortality, and high prevalence of competing comorbidities and/or prior AAA diagnosis and procedure raises the question about the likely value of a national AAA screening programme in a country such as New Zealand.}, issn = {2044-6055}, URL = {https://bmjopen.bmj.com/content/9/7/e027291}, eprint = {https://bmjopen.bmj.com/content/9/7/e027291.full.pdf}, journal = {BMJ Open} }