Cheaper and better: Simple screening for cardiovascular diseases saves more lives per krone spent than cancer screening
A new simple screening programme for diseases in the cardiovascular system saves a life for every 169 men who are invited to screening. New research from Aarhus University, Viborg Regional Hospital and Odense University Hospital shows that the programme leads to extra lifespan and is cheaper than programmes for cancer screening.
Just as many Danes die of cardiovascular diseases as cancer. However, the majority of funding ends in cancer screening. A major new study now shows that a combined screening for cardiovascular diseases delivers more lifespan per krone spent than, for example, cancer screening programmes.
"National screening programmes have been implemented for various forms of cancer, but there is limited research into similar programmes for cardiovascular diseases, despite the fact that these cause almost as many deaths," says Honorary Professor Jes Lindholt from Aarhus University. He also works at Viborg Regional Hospital and is a professor at the University of Southern Denmark.
Screening prevents unusually many deaths
More specifically, the new screening programme saves one life for every 169 men who are invited to screening for aortic aneurysm, hardening of the arteries in the legs (atherosclerosis) and high blood pressure.
"We have never seen a result of this magnitude before in population-wide screening programmes. The probability of dying is seven per cent lower if you have undergone screening. One life out of 169 is really a lot," says Jes Lindholt.
The study, which has just been presented at the world's largest cardiology conference, has also been published in the journal The Lancet.
"Aortic aneurysm, atherosclerosis in the legs and high blood pressure are often symptom free and can be life-threatening. We already knew from previous studies that an operation for a large aortic aneurysm can effectively prevent death from rupturing. But medical prevention has, if possible, an even greater effect in relation to avoiding death from blood clots in the heart and brain," explains Jes Lindholt.
One in five had undetected cardiovascular diseases
The study comprised 50,156 men aged 65-74. Half of them were invited to a screening, while the other half had the usual consultation where diseases are typically only discovered if the person reacts to symptoms or has contact with the healthcare service for other reasons. More than twenty per cent of those who participated in the screening had positive test results: Three per cent had aortic aneurysms, eleven per cent had atherosclerosis in the legs and for eleven per cent there was suspected untreated high blood pressure.
"We were surprised that one in five men had cardiovascular diseases which were undiagnosed, despite widespread access to modern technology in today's healthcare service," says Jes Lindholt.
Tremendous perspectives for public health
The researchers found benefits in the form of longer life already after five years.
"We do not have systematic screening for cardiovascular diseases today, but if we did we would be able to save more lives per krone spent than we do with our cancer screening. We often discuss what it costs to win an extra year of life. Here it will cost somewhere in the region of DKK 50,000 which is relatively low and considerably lower than for cancer screening. This is because this type of screening is simple and only needs to be undertaken once during a patient’s life. At the same time, the preventive element that follows, such as initiating medical prevention, is inexpensive. It has the potential to have tremendous positive prospects for public health," says co-author of the study, Rikke Søgaard, professor at the Department of Public Health at Aarhus University.
Background for the results:
The study is a clinical random allocation study of 50,156 men in the Central Denmark Region. Jes Lindholt has designed the study, while Rikke Søgaard has carried out the statistical analyses.
Partners: Aarhus University, Odense University Hospital and Viborg Regional Hospital.
Financial support: The European Framework Programme, the Central Denmark Region and the Danish Council for Independent Research.
Read the article "The Viborg Vascular randomised screening trial"
Professor Jes Lindholt
Aarhus University, Department of Clinical Medicine, Viborg Regional Hospital and
the Department of Cardiac, Thoracic and Vascular Surgery Heart, Odense University Hospital.
Telephone: (+45) 2244 0000
Professor Rikke Søgaard
Aarhus University, Department of Public Health
Telephone: (+45) 2899 1387