David Rose
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Delays in introducing a screening programme for a deadly blood condition are costing the lives of thousands of men each year, doctors say.
Aortic aneurysms — swellings in the main artery of the stomach — can kill without warning and are the third most common cause of death for older men. But the Government has failed to bring in a national screening programme nearly two years after it was urged to do so.
All four UK health departments are considering whether all men in their mid-sixties should be screened for an abdominal aortic aneurysm (AAA), which is found in up to one in ten men aged 65 to 79. About 7,000 men bleed to death every year because of the condition, even though it can be prevented by a simple operation.
Campaigners say that checking whether men are at risk of a ruptured aneurysm would cost £25 million, half the price of the breast cancer screening programme, and would save as many lives — at least 3,000 a year.
The UK National Screening Committee recommended the programme in January last year and sketched out how it would work in May this year.
The abdominal aorta carries blood to the intestines and other organs nearby. Aneurysms, in which the arteries weaken, stretch and bulge, are common in this part of the body. Ruptured aneurysms are catastrophic: more than 85 per cent of men die when an unsuspected aneurysm bursts, compared with only 5 per cent of those who have a planned operation. However, those at risk can be assessed by a simple ultrasound scan.
George Hamilton, president of the Vascular Society of Great Britain and Ireland, accused ministers of unnecessary delays in implementing a full screening programme. “Ruptured aneurysm is a common and painful way to die. The evidence in support of screening is incontrovertible,” he said.
The test, which involves measuring the diameter of the aorta, is funded in only a few areas, such as Gloucestershire, where a screening programme has been running since 1990. Yet doctors who offer screening to patients privately have been frustrated by criticisms that they are illegally charging for the service.
Brian Heather, a vascular surgeon who pioneered screening for AAA cases at the Gloucestershire Royal Hospital, said that the test could be performed with a briefcase-sized portable ultrasound machine.
Factors that can contribute to the likelihood of developing an aneurysm include family history and risk factors for heart disease such as smoking, obesity and high blood pressure.
Derek Kendall-Smith, 77, a former England rugby international and managing director of a jewellery firm, had surgery for an aneurysm two years ago. He said that a £95 voluntary test had saved his life. “If I hadn’t been screened I would have had no idea there was ever a problem,” Mr Kendall-Smith, of Marlow Bottom, Buckinghamshire, said.
A Department of Health spokesman said: “This assessment has to take account of the likely impact on existing healthcare services and the infrastructure and staffing requirements.”
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The NHS are not funded for carrying out these scans but the radiology department in Hereford offer private scans for £50 with half the amount going back into NHS services. Patients can refer themselves from anywhere in the UK without a doctor's letter. Any follow up scans would be covered by the NHS if needed, so this is a one-off lifetime cost.
If the government offered screening they would have to offer it to all men aged 65-79 (and maybe women too) in the first year or be accused of discrimination. Then they would be unable to cope with the number of aneurysms which would require treatment and a number of men would die waiting for surgery leaving the government open to criticism and maybe even legal action. This is why they can't offer screening not because of the cost of the scans.
Xavier Ray, Hereford, UK
My Husband survived a Ruptured Abdominal Aortic Aneurysm after emergency surgery 18 months ago. His care cost the NHS £75000 plus a £25000 Disability Grant for adaptations to the house as he was left disabled.
A scan would have saved all that money not to mention the human suffering involved.
I have an E-Petition to Downing St for The Implementation of AAA Screening. Please sign it.
http://petitions.pm.gov.uk/RAAAScreening
Anne Cheetham, Blackpool.
Anne Cheetham, Blackpool, UK
My Husband suffered a Ruptured Abdominal Aortic Aneurysm 18 months ago. He underwent emergency surgery and survived, just! He has cost the NHS £75000 plus a Disability Grant from the Government of £25000 for adaptations to the house. He was left severely disabled.
The AAA Screening programme would save the NHS and Government large amounts of money.
I have a petition to Downing Street about this . Please sign it.
The link is:
http://petitions.pm.gov.uk./RAAAScreening
Anne Cheetham, Blackpool.
Anne Cheetham, Blackpool, UK
25,000 people die in hospital every year from blood clots and deep vein thrombosis for lack of basic care and low cost drugs.
7,000 men bleed to death every year because of a ruptured aneurysm that can be prevented by a simple operation and that £25 million a year would save at least 3,000 lives.
Speed cameras that supposedly save 100 lives a year - but more likely 25 - cost well over £100m a year.
Are we quite, quite mad?
Idris Francis, Petersfield, UK