Aberdeen University Medical School, Institute of Applied Health Sciences, Aberdeen, UK.
NHS Grampian, AAA Screening Programme, Aberdeen, UK.
Br J Surg. 2015 Jul;102(8):916-23. doi: 10.1002/bjs.9803. Epub 2015 May 7.
Effective abdominal aortic aneurysm (AAA) screening requires high uptake. The aim was to assess the independent association of screening uptake with rurality, social deprivation, clinic type, distance to clinic and season.
Screening across Grampian was undertaken by trained nurses in six community and three hospital clinics. Men aged 65 years were invited for screening by post (with 2 further reminders for non-responders). AAA screening data are stored on a national call-recall database. The Scottish postcode directory was used to allocate to all invited men a deprivation index (Scottish Index of Multiple Deprivation), a Scottish urban/rural category and distance to clinic. Multivariable analysis was undertaken.
The cohort included 5645 men invited for screening over 12 months (October 2012 to October 2013); 42·6 per cent lived in urban areas, 38·9 per cent in rural areas and 18·5 per cent in small towns (uptake 87·0, 89·3 and 90·8 per cent respectively). Overall uptake was 88·6 per cent with 76 new AAAs detected: 15·2 (95 per cent c.i. 11·8 to 18·6) per 1000 men screened. Aberdeen city (large urban area) had the lowest uptake (86·1 per cent). Uptake declined with increasing deprivation, with the steepest decline in urban areas. On multivariable analysis, a 1-point increase in deprivation deciles was associated with a 0·08 (95 per cent c.i. 0·06 to 0·11) reduction in the odds of being screened (P < 0·001). Clinic type (community versus hospital), distance to clinic and season were not associated independently with uptake.
Both urban residence and social deprivation were associated independently with uptake among men invited for AAA screening.
有效的腹主动脉瘤（AAA）筛查需要高参与率。本研究旨在评估筛查参与率与农村地区、社会贫困程度、诊所类型、到诊所的距离和季节的独立相关性。
在 Grampian 进行的筛查由经过培训的护士在六个社区和三个医院诊所进行。通过邮寄向 65 岁的男性发出筛查邀请（对未回复者进行了另外两次提醒）。AAA 筛查数据存储在全国呼叫召回数据库中。苏格兰邮政编码目录用于为所有受邀男性分配贫困指数（苏格兰多重贫困指数）、苏格兰城市/农村类别和到诊所的距离。进行了多变量分析。
该队列包括在 12 个月内（2012 年 10 月至 2013 年 10 月）邀请参加筛查的 5645 名男性；42.6%的人居住在城市地区，38.9%的人居住在农村地区，18.5%的人居住在小镇（参与率分别为 87.0%、89.3%和 90.8%）。总的参与率为 88.6%，发现了 76 个新的 AAA：每 1000 名筛查男性中有 15.2 个（95%置信区间 11.8 至 18.6）。阿伯丁市（大城市）的参与率最低（86.1%）。随着贫困程度的增加，参与率下降，城市地区下降幅度最大。在多变量分析中，贫困程度增加一个等级，被筛查的可能性降低 0.08（95%置信区间 0.06 至 0.11）（P<0.001）。诊所类型（社区与医院）、到诊所的距离和季节与参与率无关。
城市居住和社会贫困程度均与受邀男性的 AAA 筛查参与率独立相关。
