Epidemiology

Prevalence of AAA is difficult to estimate since majority are asymptomatic (1).

• in the UK, prevalence is estimated to be approximately 1.3% in men who enrol in the national screening programme (at age 65) (1,4)
  
  
• a Swedish study involving ultrasonographic screening of 65 year old men reported a decline in the prevalence
  • this is thought to be due to modification of risk factors (especially smoking) (2)

Incidence of AAA is reported to be between 4.9%-9.9% (3)

• it is rare in people less than 50 years (3).
• the incidence increases sharply with each decade - starting at 50 years of age for men and 60 to 70 years of age for women
  • incidence of symptomatic AAA in men is approximately 25 per 100,000 at age 50, increasing to 78 per 100,000 in those older than 70 years (1)

It is four to six times more common in men than women.

• however the risk rupture is higher in women (3)

Around 13,000 deaths occur each year in the USA due to AAA (2). In the UK, mortality after rupture exceeds 80%, accounting for 8000 deaths annually (3).

Most AAAs are asymptomatic, and they are often diagnosed opportunistically during clinical examination or investigation for another condition. Because of this it is difficult to establish their prevalence. There is a national screening programme which enrols men at age 65 and suggests a prevalence of about 1.3% in this population (4)

• the prevalence is falling
• the prevalence of AAAs is approximately 6 times lower in women, but the rate of aneurysm rupture is significantly higher.

Reference:

• (1) National Institute for Health and Care Excellence (NICE) 2009. Endovascular stent–grafts for the treatment of abdominal aortic aneurysms
• (2) Kent KC. Clinical practice. Abdominal aortic aneurysms. N Engl J Med. 2014;371(22):2101-8
• (3) Metcalfe D, Holt PJ, Thompson MM. The management of abdominal aortic aneurysms. BMJ. 2011;342:d1384.
• (4) NICE (March 2020).Abdominal aortic aneurysm: diagnosis and management