Abdominal aortic aneurysm (AAA) screening
Temporary pause of some population screening programmes
Some population screening programmes in Northern Ireland were paused at the end of March 2020. This decision was made, in agreement with the Health Minister, so that Health and Social Care (HSC) staff and resources could be redeployed in response to COVID-19 and to reduce the risk of exposure to the corona virus for the public and HSC staff.
This position will be kept under review, but is likely to last for up to 3 months in the first instance.
The following screening programmes were paused:
- Abdominal Aortic Aneurysm screening and surveillance monitoring;
- Routine breast screening;
- Bowel cancer screening;
- Routine cervical screening; and
- Routine diabetic eye screening and surveillance monitoring.
Screening will continue to be offered to people who require:
- Higher risk breast screening. Although all eligible women will be being screened at the higher risk screening unit in Antrim Area Hospital (previously women who required mammography only were able to have their screening at their local breast screening unit).
- Diabetic eye screening for pregnant women (sight saving laser treatments and urgent intravitreal injections will continue to be provided)
- Antenatal infections screening.
- Newborn blood spot screening.
- Newborn hearing screening. However, this programme will be focused on completing screening prior to discharge from maternity units only.
- Tests for non-routine cervical screening (e.g. repeat tests requested by colposcopy or the laboratory).
Some population screening programmes in Northern Ireland have been paused for the time being. This decision has been made, in agreement with the Health Minister, so that Health and Social Care (HSC) staff and resources can be redeployed in response to COVID-19 and to reduce the risk of exposure to the corona virus for HSC staff and the public; particularly for more vulnerable groups.
The Abdominal Aortic Aneurysm Screening Programme is one of the programmes that was paused. This means that no invitation letters have been issued inviting men to attend for their initial screening during the temporary pause. The programme normally invites men in their 65th year to attend for screening.
It also continues to mean that men will not be able to self-refer for AAA screening during the temporary pause. In normal circumstances men aged over 65 who haven’t yet been screened are able to request a screening appointment by phoning the central screening office.
However, invites to men who have had a small or medium sized aneurysm diagnosed through the screening programme, to attend for ongoing surveillance, are being issued. The risk of a small or medium abdominal aortic aneurysm growing to the point of needing to be referred or rupturing (splitting or tearing) while surveillance was paused was, and continues to be, extremely low. The affected men were also informed individually of the pause in the surveillance programme by letter.
The restart of some elements of our programmes has required some changes to how we deliver the service. These changes are to make sure we can keep you and our staff safe during this difficult time.
Staff at your appointment will be wearing personal protective equipment (PPE) and our reception and waiting areas will be quieter. We would like to reassure you that there is no change to the screening test itself.
This information should help you make the decision about attending your appointment. We are following guidance to control and prevent infection and are regularly decontaminating areas and equipment. We will make sure that all staff and the men we invite for screening follow current social-distancing rules wherever possible throughout the process.
For most people, the risk of catching coronavirus at a screening appointment is no higher than if you are out and about in your community, in line with current guidance. All healthcare settings, including GP surgeries and hospital clinics, have made changes to reduce the risk of infection by coronavirus.
To reduce the risk of catching coronavirus at your appointment;
- please attend your appointment on time
- you may have to wait outside until we call you in
- you will see fewer people in the building (you will probably only see the person who is doing your ultrasound scan)
- we will do what we can to help make sure you are seen as quickly as possible
- please use the hand sanitiser which is available when you enter the building and the clinic room
- clinic staff will be wearing PPE, including a face mask, and may ask you to wear a face mask too
- please maintain the social-distancing rule between people in public spaces and in our premises at all times
- toilets may not be open in some screening clinics
If you are able to attend you appointment, it is important to do so. Screening can find early signs of a disease or condition and allows us to refer you for treatment if necessary.
You must contact us for advice before attending your screening appointment if;
- you think you have or have had symptoms of coronavirus or have had a positive test
- you or a member of your household or extended household has experienced symptoms of coronavirus or are awaiting coronavirus test results
- you have been in close contact with a person with coronavirus or been in isolation with a suspected case
- you have returned to Northern Ireland from abroad and are required to self-isolate
The symptoms of coronavirus are
- a high temperature
- a new, continuous cough
- loss or change of smell or taste
We will call you before your appointment to check whether you have any symptoms of coronavirus or are self-isolating.
Please note that the call may come from a withheld number.
In the meantime, due to the frequently changing nature of the impact of COVID-19 in different locations, please follow the government advice to stay safe and well during this time.
We have also updated the following frequently asked questions (FAQs) to the website and added some additional FAQs.
If you require further information, please contact the Programme Manager, Claire Black, on 02896 151 212.
I am almost 65 years old. When will I be invited for my AAA screening?
Please be reassured you’ll not miss out on your invitation to attend for a screening test. When routine (initial) screening re-starts, you’ll be sent an invitation through the post.
I have already been screened but have not received my result. When will I receive it?
Screening has now been temporarily paused. If you have not received your result letter please contact the Programme Manager, Claire Black, on 02896 151212.
I have an AAA and my monitoring scan is due. When will I now be invited for this?
Surveillance scans for medium AAAs recommenced in July. The programme has started issuing surveillance scan invitations for men with small AAAs.
The programme is taking all necessary steps to ensure screening invitations and appointments are prioritised appropriately.
Can I travel in and out of local lockdown areas to attend my screening appointment?
Yes, as this is a medical appointment it is a ‘reasonable excuse’ to travel (see the DOH website guidance for advice on ensuring compliance with current coronavirus regulations while attending your appointment here )
I’ve been advised to shield. Should I still go to my appointment?
If you are shielding and have been invited for screening, please call the number on your invitation letter if you have any concerns. We can discuss what we are doing to keep you safe and the options that you have. You might want to discuss your screening appointment with the health professional who usually provides your care (for example, a specialist nurse or doctor). Information about shielding may change. To find the most up-to-date advice on shielding, please go to the DOH website guidance here)
I’m self-isolating right now. Should I go to my appointment?
You should not go to your appointment if you are self-isolating or have been advised to self-isolate. This applies to you if you have symptoms of coronavirus, if you live in the same household as someone with symptoms or if you have been contacted by the Contact Tracing Service and advised to self-isolate as you have been in close contact with someone who has had a positive test for coronavirus. Please call the number on your invitation letter to change the date of your appointment.
Can someone come with me to my appointment?
Please come to your appointment on your own unless you need help from a carer or family member. Anyone not attending an appointment will be asked to wait outside. We are trying to limit the number of people in the building and waiting rooms.
Do I need to wear a face mask for my appointment?
Staff will be wearing masks when they do your ultrasound scan; you may be asked to wear a face covering/mask when you attend your appointment unless you are exempt.
What if I am unwell on the day of my appointment?
If you feel unwell on the day of your appointment, or if you think you have symptoms of coronavirus, you must stay at home.
Please call the number on your invitation letter to change the date of your appointment. If you are unable to attend your screening appointment, for any reason, please call us to rebook it. This will mean we can offer the appointment to another man.
Where can I find the most up-to-date information on public transport?
For the most recent guidance on how to travel safely, go to the DOH website guidance at here.
Signs and Symptoms
If you are worried about any changes to your health please do not wait to be invited for screening. It is very important you speak to someone at your GP surgery even if you have had a previous normal screening test.
If you have any concerns or are unsure if you should attend screening please get in touch. You can call the number on your letter or speak to one of our screeners when they call you.
Where can I get more information?
Staff at your local screening office will be happy to help with anything you need to know. The phone number for your local AAA screening office is 02896 151212. For more information on AAA screening, visit www.publichealth.hscni.net
An abdominal aortic aneurysm (AAA) is a widening of the main artery in the body, as it passes through the abdomen. The walls of the artery weaken, causing it to balloon out. It is more common in older men, smokers, people with high blood pressure and people with other cardiovascular diseases.
At the age of 65, about 1 in every 65 men will have an AAA. The aneurysm usually causes no symptoms and most people are not aware they have it. However, about a third of these will rupture (burst) if not treated. This is usually fatal and each year 80-100 people in Northern Ireland die from a ruptured AAA.
The challenge is to reduce mortality from AAA by diagnosing and treating the condition before a rupture occurs.
The equality and human rights screening template for the abdominal aortic aneurysm screening is available here: AAA_Screening_screening_template_Feb_2012.pdf
Northern Ireland AAA Screening Programme
The Northern Ireland AAA Screening Programme offers AAA screening to all men in their 65th year in Northern Ireland and was implemented in June 2012 on a phased basis within the Belfast Health and Social Care Trust area. Full roll-out of AAA screening commenced from July 2012 throughout the rest of Northern Ireland.
The aim of the AAA screening programme is to reduce AAA-related mortality by providing systematic, population-based screening using a simple ultrasound scan.
There is evidence of a significant reduction (45%) in mortality from AAA in those men aged between 65 and 79 years who undergo ultrasound screening. Men older than 65 years will be able to opt into the programme and request screening through the central screening office.
There is also evidence of the long-term cost-effectiveness of AAA screening in men and further evidence that the early mortality benefit from screening is maintained.
The items available for download here were part of the professional information packs sent out to all GPs, GP practice managers and pharmacies prior to the launch of the programme. Please note that pharmacies received a copy of the AAA screening invitation leaflet, but not the three results leaflets.
Professional information pack materials to download
The invitation leaflet is sent out to all eligible men with the letter inviting them to screening. The results leaflets are for men diagnosed with a small, medium or large AAA. The relevant result leaflet will be given to screened men directly after their scan.
The poster was sent out to all GPs, GP practice managers and pharmacies in the run-up to the launch of the programme as a means of raising awareness.
The frequently asked questions address issues relating to all aspects of the programme: what an AAA is, roll-out of the programme, the screening process, the scan itself, possible results, available treatment, and how personal information is used.