Case study of abdominal aortic aneurysm screening programs in other countries and feasibility study of a national screening program for South Korea

ABSTRACT

Abdominal aortic aneurysm (AAA) is a disease in which the abdominal aorta is swollen to a diameter as large as 3.0cm or even more. Although the symptoms are usually not prominent, it is fatal once it bursts. If AAA is diagnosed early and treated, the majority of deaths from ruptured AAA can be prevented. It is screened for with ultrasonography, which is a fast, cheap and safe diagnosis tool. Most patients can also tolerate the screening well. Several countries are operating national AAA screening programs in efforts to reduce AAA-related deaths. For instance, the Screening Abdominal Aortic Aneurysms Very Efficiently program in the United States and the National Health Service Abdominal Aortic Aneurysm Screening Programme in the United Kingdom are some of the prominent programs currently available. If Korea conducts AAA screening programs for a target population similar to these cases, the cost is estimated to be 25.7 billion Korean won (23.4 million US dollars [USD]). If the target population is extended to males 65 years of age and above with experience smoking more than 5 pack-years of cigarettes, the cost is estimated to be 36.4 billion Korean won (33.1 million US dollars [USD]). However, considering the actual screening rate of the current national cancer screening program, the realistic costs are estimated to be 10.6 billion Korean won (9.7 million US dollars [USD]) and 15.0 billion Korean won (13.7 million US dollars [USD]), respectively. Given the success of AAA screening programs in other countries, it is necessary to introduce a national AAA screening program in Korea.