Our research: case studies

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Screening and Treatment for Abdominal Aortic Aneurysm

Cambridge researchers led a randomised trial to see whether performing ultrasound screening would identify men likely to develop a dangerous AAA, and investigate if early screening can provide long-term benefits.

Abdominal aortic aneurysm (AAA) is an enlargement of the abdominal aorta. It is predominantly found in men over the age of 65, and when it increases in size it can be dangerous and in some cases deadly.

Cambridge researchers led a randomised trial to see whether performing ultrasound screening would identify men likely to develop a dangerous AAA, and investigate if early screening can provide long-term benefits. This was then followed up by a further health economic assessment of AAA screening.

After inviting more than 33,000 men to ultrasound screening and analysing their results against a comparable group not invited, researchers were able to show that population screening of men over 65 could halve the number of deaths from AAA over a 10-year period.

In 2013, the Department of Health in England introduced a national screening programme for men over 65, based on the data from Cambridge researchers which helped shape their policy. A year later Wales, Scotland and Northern Ireland introduced AAA screening for men, and other countries have also adopted the programme.

This national AAA screening programme has saved many lives via early detection and treatment of AAA.

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Reviewing the NHS Health Check programme

The NHS Health Check programme was introduced across England in 2009 for people aged 40 and above who do not have known health conditions. People take the checks at their local surgery to find out their risks of developing conditions such as heart disease, stroke and diabetes.

The NHS Health Check programme offers people information on how to reduce their risk and/or early treatment. Many of the recommended lifestyle changes also lower the risk of other diseases, such as cancer and lung disease.

Under the current ‘one size fits all’ guidelines, the checks are available to all apparently healthy people every five years until they reach 75. However, within this group some will be at higher risk of future disease and may benefit from earlier and more frequent health checks – while those at lower risk will need fewer checks.

To identify people with greatest health needs, researchers have been developing methods to use data from electronic health records (which all patients have), including measurements of the “risk factors” that are known to be linked with greater risk of disease. These include smoking, being older, being overweight, and having high blood pressure and high cholesterol.

GPs will be able to use this tool to estimate when individuals should next be invited for an NHS health check. This may help increase the cost-effectiveness of the programme while directly benefiting those at highest risk of future disease.