Published February 2020
Contents
― Summary of things you need to know about AAA
Abdominal aortic aneurysm (AAA) screening summary
The aorta is the main blood vessel that supplies blood to the body. Sometimes the wall of the aorta in the abdomen can become weak and stretch to form an aneurysm. When this happens there is a risk that the aorta may split or tear (rupture).
We will invite you for AAA screening if you are a man, aged 65, who lives in Wales and who is registered with a GP practice.
AAA screening involves a simple ultrasound scan to measure the abdominal aorta.
The scan may be slightly uncomfortable due to pressure on the abdomen.
It is a free NHS screening test.
If you are not in the screening age group and are concerned that you may have an AAA or are worried about a family history of AAA, you should speak to your GP.
Like all medical tests, AAA screening is not 100% accurate.
It is your choice whether to have AAA screening or not. This leaflet gives you information to help you decide.
The NHS offers screening to save lives from a ruptured (splitting or tearing) abdominal aortic aneurysm (AAA).
The aorta is the main blood vessel that supplies blood to the body. Sometimes the wall of the aorta in the abdomen can become weak and stretch to form an aneurysm. When this happens there is a risk that the aorta may split or tear (rupture). A ruptured AAA can lead to serious blood loss that will need immediate emergency treatment. Not every AAA will rupture, but if it does the chances of getting to hospital and surviving surgery are very poor.
An AAA can happen to anyone but it is most common in men aged 65 and over who one (or more) of the following applies to:
Anyone known to have a close family history of AAA, and who is not invited for screening (for example, men who are not yet aged 65 or women of any age) should discuss any concerns they may have with their GP.
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We invite men aged 65 to be screened if they live in Wales and are registered with a GP practice.
If you are over 65 and have never been for an NHS AAA screening scan, you can ask for a scan by contacting your local screening programme.
Men are six times more likely to have an AAA than women. A ruptured AAA is less common in women and on average happens 10 years later than in men. The National Screening Committee does not recommend that AAA screening is offered to women. Women who have a family history of AAA should speak to their GP, who will be able to advise them.
There are usually no signs or symptoms if you have an AAA. This means that you may not feel any pain or notice anything different. If you go to AAA screening, we can find an AAA earlier and offer you monitoring or treatment.
The easiest way to find out if you have an AAA is by having a simple ultrasound scan of your abdomen.
The scan used to find an AAA is very reliable but like any medical test, AAA screening is not 100% accurate. Sometimes results can be reported wrongly but this is very rare. This means that a person may be told that they have an AAA when in fact they don’t, or a person may be told that they don’t have an AAA when they do.
The screening programme regularly checks records to make sure the service is as good as possible. If you want to know the results of these regular checks, you can contact your local screening unit.
Screening finds AAA early so they can be monitored or treated. About 98 men out of every 100 (98%) who are screened for an AAA are told that no aneurysm has been found and are not offered any further tests.
AAA screening involves having an ultrasound scan to measure the size of your abdominal aorta. It is the best way of detecting an AAA. To have a clear scan of your abdominal aorta the screener will need to press on your abdomen.
The ultrasound scan for AAA screening only takes a few minutes. We monitor the quality and accuracy of your AAA scan and if there is any concern about your scan measurements we may invite you for another AAA scan.
No. AAA screening is just to find out if you have an AAA. It does not look for other health problems. If you are worried about your health, you should speak to your GP.
Your screening appointment will usually take about 10 to 15 minutes.
The screener is the trained person who will check your personal details when you arrive, ask for your consent (permission) and carry out your ultrasound scan.
If you are worried about anything you can ask the screener at any time.
An ultrasound machine uses sound waves to create an image on a computer screen.
The screener will explain what will happen during the scan. You will not need to undress. The screener will ask you to lie on your back and lift up your shirt or top so that they can see your abdomen.
The screener will put some clear gel on your abdomen and pass an ultrasound probe over your abdomen.
So that the screener can get a clear image of the abdominal aorta, they may need to apply some pressure when using the probe.
An image of the aorta will be displayed on a monitor. The screener will measure the size of the aorta to see if an AAA is present.
The screener will give you your results following your scan. The four possible results that you may get after your ultrasound scan are as follows.
If your aorta is less than 3 cm wide, this means you do not have an aneurysm. About 98 men out of every 100 (98%) who are screened for an AAA are told that no aneurysm has been found and are not offered any further tests. You don’t need treatment or monitoring. We will not invite you for AAA screening again.
If your abdominal aorta is between 3 and 4.4 cm wide, you have a small AAA. If your abdominal aorta is between 4.5 and 5.4 cm wide, you have a medium AAA. About two men out of every 100 (2%) screened are told they have a small or medium AAA. We will invite you to have regular ultrasound scans to check the size of your AAA. How often you will need a scan will depend on the size of your AAA. You may also need medication, which will be prescribed by your GP. A small or medium AAA carries less risk of rupture than a large AAA.
If your abdominal aorta is 5.5 cm wide or bigger you have a large AAA. One man out of 1000 (0.1%) screened are told they have a large AAA. We will refer you to a specialist team at a hospital who will carry out more tests and talk with you about your options for treatment.
Treatment may include having an operation. For a small number of men, an operation will not be possible.
Some AAA operations carry significant risks but the chances of recovery are much better if the operation is planned.
If you have an AAA of any size and are planning a holiday you should tell your travel insurance provider.
The specialist team will tell you whether or not you need to tell the DVLA (Driver Vehicle Licensing Agency).
The DVLA say that you must tell them if you have an aortic aneurysm that is over 6 cm in diameter. The screening programme refers men with an aneurysm of 5.5 cm or bigger.
It is therefore very unlikely that having an AAA diagnosed or being monitored by the screening programme will affect you holding a valid driving licence. The DVLA are responsible for deciding whether people can drive on the basis of their health or any conditions they may have.
You can find the current advice on the GOV.UK website.
Your GP and the hospital specialist team can advise you whether or not you should drive.
In very rare cases the screener may not be able to measure your abdominal aorta and we will offer you further scans. This is nothing for you to worry about. This may happen for a number of reasons and the screener will explain this to you during the screening appointment.
It is your choice whether or not you have AAA screening. There are many different reasons why men decide whether or not to have screening. To help you decide, we’ve included information on the possible benefits and risks.
Lives are saved because AAA are identified and treated earlier than they would have been without screening.
Some men will be identified with an AAA that would never otherwise have been found and would not have become life-threatening. This is the main risk of screening.
We are an NHS organisation. We get your name and address from a national database called the Welsh Demographic Service which is managed by the NHS Wales Informatics Service. This database holds a record of names and addresses for every person living in Wales who is registered with a GP.
We need to keep your personal information so we know if and when you have had a scan or whether you have decided not to have one. For us to contact you as part of this programme, we will need to handle some of your personal information.
If you need information about this, you can:
If you need any more information you can:
Using your information when you access the service
Circulation Foundation (a charity supporting people with vascular disease)
Phone: 020 7205 7151
If you want to change your appointment, you can contact your local screening centre.
The following information is based on the best available evidence