The Health Information and Quality Authority has launched a public consultation on its draft health technology assessment (HTA) of screening for abdominal aortic aneurysm (AAA) in men.

HIQA was asked by the National Screening Advisory Committee to undertake this assessment. The assessment will provide evidence-based advice to NSAC to support a recommendation on whether to introduce an AAA screening programme for men in Ireland.

An abdominal aortic aneurysm (AAA or ‘triple A’) is a swelling or ballooning of the aorta. The aorta is the largest artery in the body and carries blood from the heart to the rest of the body. AAA is uncommon in the general population but becomes more prevalent with age, particularly in men. Among men aged 65 years, fewer than 1 in 100 are affected. Typically, an AAA has no symptoms, but can grow and burst if left untreated, which is usually fatal. Early detection may reduce the risk of dying from AAA rupture.

This HTA assesses the clinical effectiveness, safety, cost effectiveness, budget impact, and organisational and ethical considerations associated with screening for AAA in men.

The draft findings of this HTA have now been published and HIQA is seeking feedback from the public on the draft report. A survey, which can be completed online or downloaded and filled out, is available at www.hiqa.ie. The deadline for submissions is 5 pm on 12 June 2025.

Following the public consultation, the report will be finalised and submitted as advice to NSAC to inform its recommendation to the Minister for Health, and subsequently published on the HIQA website.

Dr Máirín Ryan, HIQA's Deputy CEO and Director of Health Technology Assessment said: “AAA screening could save lives by finding AAAs earlier, so they can be monitored or treated with surgery. It can be challenging to identify which cases of AAA are likely to burst without surgery, and which cases are unlikely to cause problems. Surgical repair of AAA is not without risks, so it is important that the benefits and harms of screening and subsequent treatment are carefully considered.”

Dr Ryan continued: “Another factor to consider is the impact of declining AAA prevalence. AAA is becoming less common in the population, partly due to changes in smoking patterns, as smoking is a major risk factor. With this reduction in prevalence, the number of lives that could potentially be saved through screening also decreases. This must be weighed against the resources required to implement and run the screening programme.”

Read the draft report and take part in the consultation.

Ends.

For further information please contact:

Marty Whelan, Head of Communications and Stakeholder Engagement
085 805 5202 | mwhelan@hiqa.ie 

Notes to the editor:

• The Health Information and Quality Authority (HIQA) has today published the following document:
  • Draft health technology assessment of abdominal aortic aneurysm (AAA) screening in men.
• The National Screening Advisory Committee (NSAC) was established in 2019 as an independent advisory committee to advise the Minister for Health and Department of Health on all new proposals for population-based screening programmes and revisions to existing programmes. Further information on the NSAC is available here.
• HIQA has been requested by the Department of Health to provide evidence synthesis support and evidence-based advice to the NSAC under an agreed work programme.
• Currently, in the absence of a national AAA screening programme in Ireland, patients with an AAA are usually identified by chance during imaging for other indications.
• The aim of screening is to identify people in an apparently healthy population with pre-clinical or asymptomatic disease so that an early treatment can be offered, where appropriate.
• Ultrasound is the recommended imaging modality for diagnosis, screening, and surveillance of small AAAs.
• An AAA is typically defined as an aortic diameter of 3.0 cm or more. In most men, the normal diameter of the abdominal aorta is approximately 2.0 cm.
• Screening may lead to overdiagnosis - the detection of a disease or condition that would never have produced symptoms or problems if undiagnosed. The possible outcomes of overdiagnosis are significant, including potential
  psychological effects, potential treatment-related adverse events, and wasted resources.
• In Ireland, the prevalence of AAA is unclear due to the absence of up-to-date epidemiological studies or a national vascular database. Based on data from the UK AAA screening programme, the prevalence of AAA in men aged 65 years is likely less than 1%.