A letter inviting you for an abdominal scan may come as a surprise, especially if you feel perfectly well. Yet abdominal aortic aneurysm screening for men in the UK is designed for exactly that situation: finding a potentially serious problem before it causes symptoms. The appointment is brief, the test is painless, and most men leave knowing that no further screening is needed.
What is an abdominal aortic aneurysm?
The aorta is the body’s main artery, carrying blood from the heart through the chest and abdomen. An abdominal aortic aneurysm, often shortened to AAA, happens when part of the aorta in the abdomen becomes wider than normal because its wall has weakened.
Many aneurysms grow slowly and never cause trouble. The concern is that a large aneurysm can rupture, causing dangerous internal bleeding. Because an AAA usually produces no warning signs, waiting until something feels wrong is not a reliable way to detect one.
Which men are offered AAA screening in the UK?
Across England, Scotland, Wales and Northern Ireland, the NHS offers a one-off aortic aneurysm scan to eligible men around the age of 65. Invitations generally arrive automatically, although precise timing and administration vary between the four nations. In England, the invitation may arrive when a man is 64 or 65 as part of the screening year in which he turns 65.
Men older than 65 who have never been screened can normally contact their local AAA screening service to arrange a scan. If you have already been diagnosed with an aneurysm or had an AAA repair, you need the appropriate clinical follow-up rather than another routine screening invitation.
Screening is not routinely offered to younger men or women because their average risk is lower. However, anyone with a close family history of AAA should discuss individual risk with a GP. Some transgender and non-binary people may also be eligible; ask the screening service if your invitation does not reflect your medical needs.
Why age 65 matters, even without symptoms
Age and being male are major risk factors. Smoking, high blood pressure and having a parent or sibling with an aneurysm increase risk further. Having none of these additional factors does not make screening pointless.
The purpose of AAA screening UK programmes is not to predict who will become ill tomorrow. It is to identify an enlarged aorta while there is still time to make informed decisions. Screening is optional, and it is reasonable to ask about its benefits and possible downsides, including worry caused by finding a small aneurysm that may never need surgery.
What happens at the screening appointment?
The abdominal ultrasound screening procedure is straightforward. A trained screening professional confirms your details, explains the test and asks for your consent. You lie on an examination couch and lift your shirt to expose your stomach.
Cool gel is applied to the skin, and a small handheld probe moves over your abdomen. Sound waves create an image of the aorta, allowing its width to be measured. There are no needles, no X-rays and usually no discomfort beyond a little pressure from the probe.
The scan itself typically takes about 10 minutes, although the whole visit may take longer. Follow any preparation instructions in your invitation; for example, some services advise avoiding a heavy meal beforehand. You are usually told your result before leaving.
Understanding your AAA screening result
No aneurysm found: under 3 cm
This is the result for most men. The aorta is not enlarged, and you will not normally need another routine AAA screening appointment. It does not mean every future abdominal symptom can be ignored.
Small aneurysm: 3.0 to 4.4 cm
A small AAA usually does not require immediate surgery. The screening programme generally invites you for an ultrasound every 12 months to check for growth. You may also be offered advice from a vascular nurse or another clinician.
Medium aneurysm: 4.5 to 5.4 cm
A medium AAA needs closer observation. Repeat scans are generally arranged every three months. The team watches not only its current size but also how quickly it changes, because faster growth can affect the next steps.
Large aneurysm: 5.5 cm or more
A large AAA triggers prompt referral to a vascular specialist, typically with an appointment within two weeks. The specialist will discuss further imaging, your general health and whether an operation is appropriate. A referral does not mean surgery is automatic: the benefits and risks must be weighed for you individually.
Occasionally, bowel gas or other factors prevent a clear view of the aorta. An inconclusive scan is not the same as finding an aneurysm; the service will arrange another scan or a different imaging appointment.
What should you do after an abnormal result?
Keep the written measurement and attend every follow-up scan, even if you still feel fine. Ask whom to contact if an appointment letter does not arrive. Stopping smoking is especially valuable, while managing blood pressure and other cardiovascular risks with your GP supports overall vascular health. Do not start or stop medication based solely on a screening result.
For example, a 68-year-old who missed his original invitation can contact his local screening programme rather than assuming he is too old. If his scan shows a 3.8 cm aneurysm, he will generally enter annual surveillance, not be rushed into an operation. Knowing that distinction can make an unexpected result less frightening.
It may also help to review how blood pressure readings are interpreted and which preventive health checks are routinely offered to older men, alongside your AAA follow-up.
When symptoms need urgent attention
AAA screening is intended for people without symptoms. Speak to a GP about persistent or recurring abdominal or back pain, particularly if you have an aneurysm or relevant risk factors. Sudden, severe pain in the abdomen or back, collapse or signs of shock could signal a rupture. Call 999 immediately. Do not wait for a screening appointment.
Frequently asked questions
Is AAA screening free on the NHS?
Yes. Eligible men are offered screening through NHS programmes in the four UK nations without a charge.
Can I request screening if I am over 65?
Usually, yes, if you have never had an AAA screening scan and have not already been diagnosed with an aneurysm. Contact your local screening service for the rules in your area.
Is the aortic aneurysm scan painful?
No. Ultrasound uses a probe and gel on the skin. It does not involve an injection or exposure to ionising radiation.
Will I need screening every year?
Not after a normal result. Annual scans are generally offered only when a small aneurysm is found; medium aneurysms are usually checked every three months.
Making an informed choice
AAA screening for men at 65 is a small appointment with potentially significant consequences. For most people, it brings reassurance. For a smaller number, it identifies an aneurysm early enough for monitoring or specialist care. If your invitation arrives, read it, ask questions and decide whether to attend. If your 65th birthday has passed without a scan, you can still ask your local NHS screening service about arranging one.