Background: Although women represent an increasing proportion of those now presenting with abdominal aortic aneurysm (AAA) rupture, the current prevalence of AAA in women is unknown. The contemporary population prevalence of screen-detected AAA in women by both age and smoking status was investigated.

Methods: Systematic review of studies screening for AAA, including >1000 women, aged ≥60 years, undertaken since the year 2000, searching MEDLINE, EMBASE and CENTRAL databases until 13th January 2016. Study quality was assessed using the Newcastle-Ottawa scoring system.

Results: Eight studies were identified, including only 3 based on population registers. The largest studies were based on self-purchase of screening. Altogether 1,537,633 women were screened. Overall AAA prevalence rates were very heterogeneous, ranging from 0.37 to 1.53%: pooled prevalence 0.74% [95%CI 0.53, 1.03]. The pooled prevalence increased with both age (>1% for women >70 years) and smoking (>1% for ever smokers and >2% in current smokers).

Conclusions: The current population prevalence of screen-detected AAA in older women is subject to wide demographic variation. However, in ever smokers and those over 70 years, the prevalence is >1%.

Registration: PROSPERO database of systematic reviews CRD42015020444