Four RCTs were included in the review (n=114,376 participants). One trial was rated as good quality and three were rated as fair quality. The length of follow-up ranged from 10 to 15 years.
All-cause mortality: There was a statistically significant reduction in the rate of abdominal aortic aneurysm-related all-cause mortality (OR 0.55, 95% CI 0.36 to 0.86; I2=78%; three RCTs) with abdominal aortic aneurysm screening compared with no screening. This equated to an absolute risk reduction of four deaths per 1,000 men aged 65 years or over compared with control (unscreened men). and a number needed to screen to detect an aneursym of 238.
Long-term mortality: There was a non-significant reduction in abdominal aortic aneurysm-related long-term mortality (OR 0.98, 95% CI 0.95 to 1.00; I2=0%; four RCTs) with screening compared with no screening. This equated to an absolute risk reduction of five deaths per 1,000 men. The number needed to screen was 217.
The analyses using hazard ratios produced similar results.
There was no evidence of significant publication bias.