Wales Abdominal Aortic Aneurysm Screening Programme (WAAASP) aims to halve abdominal aortic aneurysm (AAA) related mortality by 2025 in the eligible population. Men over the age of 65 are invited to attend for a one-off ultrasound screening.
A total of 19,428 people were invited to take part in AAA screening in 2021/22, with 16,078 people taking up the offer. This compares to 4,209 people invited in 2020/21 and 3,562 people taking up the offer as this was the year of the pause and phased restart. The number invited exceeds the number invited in 2018/19 (17,045), which reflects the efforts undertaken by the programme to increase capacity and aid recovery whilst still operating under some Covid restrictions.
Uptake is reported as the proportion of eligible invited participants that were screened within six months of invitation making this the latest available data as of October 2021. Across Wales in 2021/22 uptake of AAA screening was 82.8%. This exceeds the minimum standard of 80%.
There is geographical variation across health board areas ranging from the lowest of 80.5% in Cardiff and Vale UHB to a highest of 85.5% in Powys Teaching HB (table 5). The highest and lowest are different to last year, and the gap is smaller (5 compared to 7.4 percentage points), and all health boards meet the 80% standard.
Table 5: Uptake (%) of AAA screening by health board of residence, 2021/22
|
Health board |
Invited (n) |
Tested (n) |
Uptake (%) |
|
Aneurin Bevan UHB |
3,534 |
2,874 |
81.3 |
|
Betsi Cadwaladr UHB |
4,516 |
3,835 |
84.9 |
|
Cardiff & Vale UHB |
2,332 |
1,877 |
80.5 |
|
Cwm Taf Morgannwg UHB |
2,780 |
2,328 |
83.7 |
|
Hywel Dda UHB |
2,731 |
2,236 |
81.9 |
|
Powys Teaching HB |
987 |
844 |
85.5 |
|
Swansea Bay UHB |
2,545 |
2,082 |
81.8 |
|
All-Wales |
19,428 |
16,078 |
82.8 |
Geographical variation in uptake of AAA screening also exists at a local authority level ranging from a lowest uptake in Cardiff at 77.7% with the highest in Denbighshire at 89.1% (Figure 13). There is a wider variation at local authority than health board level, though the difference has decreased from 12.6 to 11.4 percentage points from 20-21.
Figure 13: Uptake (%) of AAA screening by local authority of residence, 2021/22
Description of Figure 13: Bar chart showing the pattern of AAA screening uptake in each of the 22 local authorities. This ranges from 89.1% in Denbighshire to 77.7% in Cardiff.
Across Wales, in 2021/22, uptake of AAA screening was highest in the least deprived quintile at 87.3%, and lowest in the most deprived quintile at 74.9%. The inequity gap, representing the difference between uptake in the least deprived communities compared to the most deprived communities, was 12.4%. The gap has increased from 2020/21 when it was 8.4%, and uptake has fallen in the most deprived groups, causing this increase.
However, the pattern for a linear decline in uptake as deprivation increases is not perfectly demonstrated in all health board areas, although the trends are still there. Interpretation should consider the smaller number of invited participants at smaller geographical areas as these will be more susceptible to fluctuations in trend data.
Figure 14: Uptake of AAA Screening by deprivation quintile – all-Wales 2021/22
Description of figure 14: Bar chart showing how AAA screening uptake decreases as level of deprivation increases. Uptake in the least deprived group is 87.3% but 74.9% in the most deprived group.
Figure 15: Uptake of AAA Screening by deprivation quintile by health board 2021/22
Description of Figure 15: Clustered Bar chart showing the pattern of AAA screening uptake by deprivation in each of the seven health boards. The overall pattern shows that uptake decreases as deprivation increases.
The inequity gap in 2020/21 was greatest in CVUHB at 17%. However, in some health board areas such as Powys a narrower inequity gap of 4.9% is present.