Epidemiology

Epidemiology varies by region, age, ethnicity, and sex, with large screening studies offering the closest approximation. A screening study of US veterans ages 50 to 79 years found the highest prevalence of AAA (AAA >3 cm) among white male smokers (5.9%).[14] Prevalence among men is 4 to 6 times higher than in women.[1][15]​​ According to data from the UK National Health Service (NHS) AAA screening program, of the 291,904 men eligible for their initial AAA screen between 1 April 2019 and 31 March 2020, 76.1% were screened by 31 March 2020 and 0.92% had an aneurysm. There were 8340 men ages over 65 who self-referred into the UK NHS AAA screening program and 88.9% were screened by 31 March 2020; the aneurysm detection rate in self-referred men was higher than cohort men, at 3.8%.[16]​ 30 patients that had AAA detected in this screening year had a subsequent ruptured AAA; 25 of which were fatal.[16]​

A systematic review of studies reporting screen-detected AAA in women found that the pooled prevalence of AAA increased with age (>1% for women >70 years of age) and with smoking status (>1% for female ever-smokers; >2% for current smokers).[17] The prevalence of aneurysms among men increases by about 6% per decade of life.[13] In 2019 there were 9904 deaths attributed to AAA in the US.[18]

In the UK, deaths from AAA declined sharply from 1997 to 2009, with mortality in men ages >65 years falling from 65.9 to 44.6 per 100,000 population.[19] Admissions for ruptured AAA fell from 18.6 to 13.5 per 100,000 in all age groups. The reduction in mortality and admissions has been attributed to the fall in smoking prevalence and the rise in elective AAA repair in older age groups.[19]​ Current data from the AAA screening program in the UK show AAA to be more common in white British (and in particular white Irish) men than in black or Asian men.[20]

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