Screening of XXXX : a pragmatic approach.

@entity1 @entity439 @entity1028 @entity397
In order to evaluate the feasibility of a selective screening programme for @entity1028 ( @entity1028 ) within an urban setting and assess its impact on the expected increase in workload for the local hospital(s), a population based, prospective study was performed. A total of 4823 @entity1 aged 65 years were invited for ultrasound examination of the abdominal aorta between January 1993 and April 1997 as part of a general practice-based @entity439 screening programme covering two districts with a general hospital each. All examinations were carried out by senior radiographers using a portable B mode grey scale machine and a 3.5 MHz curvi-linear array probe. @entity1 with a maximum aortic diameter of over 3 cm were annually recalled, those with over 4 cm were referred to hospital for an out- @entity1 's appointment. Those with @entity1028 greater than 5 cm were considered for surgery. Of those approached, 3497 (72.5%) took part in the study, 1206 (25%) did not attend and 120 (2.5%) were excluded by their general practitioners (GPs) on medical grounds. Of the @entity1 taking part, 3130 (89.5%) had an aortic diameter equal to or less than 2.5 cm, 196 (5.6%) between 2.6 and 3.0 cm, and 171 (4.9%) had aortic diameters greater than 3 cm--29 of whom had @entity1028 greater than 5 cm with a mean diameter of 6.0 cm (range 5.1-9.0 cm). Of 127 @entity1 with an initial diameter of 3.1-4.0 cm (mean progression in size of 2.3 mm/year), 22 enlarged to > 4 cm and 3 to > 5 cm. Of 24 @entity1 with an initial diameter of 4.1-5.0 cm, 6 enlarged to > 5 cm. Some 69 (2%) @entity1 were referred to hospital requiring a total of 125 consultations (1.8 consultations per @entity1 ); 21 underwent surgery and one died from @entity397 whilst awaiting surgery. Five @entity1 refused their operation and two failed to attend the clinic (all > 5 cm) but remain well to date. No @entity1 died following surgery. We conclude that, screening for @entity1028 in @entity1 at age 65 years within an urban setting is feasible and well received by @entity1 and GPs. Screening does not lead to a huge increase in terms of outpatient appointments and operations for @entity1028 .
