Tuesday, April 11, 2006

'Aneurysm Tests Urged in Older Men Who Smoked'

This week is the one-year anniversary of when my Dad went into the hospital with a ruptured abdominal aortic aneurysm and ultimately died.

Ironically, just about two months previously, I'd sent my Dad an email with a New York Times article "Aneurysm Tests Urged in Older Men Who Smoked" explaining how men over 65 who'd ever smoked should be screened for aneurysms. He'd printed out the article, I think (I hope) with the intention of bringing it up at his next doctor's visit.

I didn't remember that I'd sent the email to my Dad until my sister found it in his email inbox days after he'd died. I'd prefaced it with "Just thinking about you, Dad. :) Love, Haley". We were all a little spooked at finding it.

I won't reprint the whole article, since it's still available without fee on the New York Times website, but I will excerpt from it. It was originally published Feb. 1, 2005.

The task force estimated that for every 500 men who meet its criteria and are screened, one death would be prevented over five years. In comparison, the only test for colorectal cancer that was evaluated in a randomized controlled trial, the fecal occult blood test, requires that 1,374 people be screened to prevent one death over five years.

"This is huge," said Dr. Frank A. Lederle of the University of Minnesota and the Minneapolis Veterans Affairs Medical Center, who reviewed the clinical trial data for the task force. "A major test for a major disease - it just doesn't come along very often."

Almost no one is screened now for abdominal aortic aneurysms, vascular surgeons say. Medical researchers suspect the true death rate is higher than 9,000 a year because often the swift deaths are attributed to a heart attack or stroke.

"If it ruptures, you're dead," Dr. Lederle said. Most bleed to death so quickly that they never make it to the hospital. And half of those who do make it to the hospital do not survive.

The review of the trial data on abdominal aortic aneurysms, along with the task force's recommendations, is published today in the Annals of Internal Medicine.

An abdominal aortic aneurysm is a small weakened area of the aorta, the large artery that carries blood from the heart and winds down along the spinal cord to the abdomen. Over the years, the weak spot slowly balloons and eventually bursts. There are no symptoms as the aneurysm grows. But once it reaches five and a half centimeters, or a little over two inches, in diameter, it may burst at any moment. That is the time to repair it, medical researchers say, explaining that smaller aneurysms posed too little danger to be worth the risk of operating on them.

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