Aneurysm screening for men to roll out in Cork

A simple screening programme that has detected 11,000 potentially fatal aneurysms in men in the UK is being rolled out across five GP practices in Cork.

The screening, by ultrasound, can pick up abdominal aortic aneurysms (AAA), a dangerous swelling of the aorta, the main vessel that runs from the heart down through the abdomen to the rest of the body.

If it ruptures, up to three in 10 men affected die before reaching hospital and another 60% make it to hospital, but die within a month, according to Diarmuid Quinlan, of Woodview Family Doctors, in Glanmire.

Women are six times less likely to be affected. The condition, which has no symptoms, affects 4-5% of men in the 65-79 age group, said Dr Quinlan. The NHS invites all men for free screening the year they turn 65.

Dr Quinlan’s practice, along with a practice in Fermoy, Co Cork, and three more in Mallow, Co Cork, is conducting its own own AAA screening project.

“Our plan is to invite about 1,200 men,” said Dr Quinlan. “We know that, usually, about half of those invited take up the offer. Of that figure, we expect to diagnose 25-30 aneurysms, including five or six large aneurysms.”

Once an aneurysm is detected, Dr Quinlan said it’s “relatively straightforward to treat” — it can be cut out or a stent can be inserted via the groin.

Large aneurysms pose the greatest danger. Under the UK screening programme, if the abdominal aorta is not enlarged (less than 3cm), the man does not need to be tested again. Small- to medium-sized aneurysms (3cm-5.4cm) require regular monitoring to check growth. A man with a large aneurysm (5.5cm+) will be referred to a specialist, who will advise on treatment to reduce the risk of it bursting.

The same process is expected to apply here. The Mater Private, in Cork, and Euromedic/Affidea will carry out the scans and those in need of follow-up will be referred to Gerald McGreal, vascular surgeon at the Mercy University Hospital (MUH).

Dr Quinlan said scans will be carried out at a reduced rate — instead of €150, they will cost €90 for those without a medical card and €70 for those with a medical card.

“To date, in Glanmire, we have screened 45 men and picked up three small aneurysms,” Dr Quinlan said.

He said the objective is to make AAA screening “a national project.

“To my mind, these men are dropping dead, depriving families of fathers and grandfathers at a very important time in their lives,” said Dr Quinlan.

Those who made it to hospital remained in ICU, and it was “extremely expensive” to look after them. Screening was relatively cheap and the experience in the UK was that it was a major public health success story, preventing thousands of premature deaths. The NHS screened its “one millionth man” in January, 2016.

“They have looked at it and they think it is cost-effective,” said Dr Quinlan. “It took them four years to get full national coverage, so we are way behind the curve.”

The HSE told the Irish Examiner that there are “no plans for any such screening programme”, but that, ultimately, the introduction of any new screening service is a policy decision for the Department of Health.

Dr Quinlan will give a presentation on AAA at the upcoming European Patient Safety Conference, in Dun Laoghaire, next month.



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