Cited by 183Health Promotion and Cardiovascular PreventionCardiac Imaging and DiagnosticsHealthcare Systems and Public Health

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Five-Year Outcomes of the Danish Cardiovascular Screening (DANCAVAS) Trial

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Lindholt, Jes S., Søgaard, Rikke, Rasmussen, Lars M., Mejldal, Anne, Lambrechtsen, Jess, Steffensen, Flemming H., Frost, Lars, Egstrup, Kenneth, Urbonaviciene, Grazina, Busk, Martin, Diederichsen, Axel Cosmus Pyndt·2022·New England Journal of Medicine

DOI 10.1056/nejmoa2208681

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Abstract

BACKGROUND: Limited data suggest a benefit of population-based screening for cardiovascular disease with respect to the risk of death. METHODS: We performed a population-based, parallel-group, randomized, controlled trial involving men 65 to 74 years of age living in 15 Danish municipalities. The participants were randomly assigned in a 1:2 ratio to undergo screening (the invited group) or not to undergo screening (the control group) for subclinical cardiovascular disease. Randomization was based on computer-generated random numbers and stratified according to municipality. Only the control group was unaware of the trial-group assignments. Screening included noncontrast electrocardiography-gated computed tomography to determine the coronary-artery calcium score and to detect aneurysms and atrial fibrillation, ankle-brachial blood-pressure measurements to detect peripheral artery disease and hypertension, and a blood sample to detect diabetes mellitus and hypercholesterolemia. The primary outcome was death from any cause. RESULTS: A total of 46,611 participants underwent randomization. After exclusion of 85 men who had died or emigrated before being invited to undergo screening, there were 16,736 men in the invited group and 29,790 men in the control group; 10,471 of the men in the invited group underwent screening (62.6%). In intention-to-treat analyses, after a median follow-up of 5.6 years, 2106 men (12.6%) in the invited group and 3915 men (13.1%) in the control group had died (hazard ratio, 0.95; 95% confidence interval [CI], 0.90 to 1.00; P = 0.06). The hazard ratio for stroke in the invited group, as compared with the control group, was 0.93 (95% CI, 0.86 to 0.99); for myocardial infarction, 0.91 (95% CI, 0.81 to 1.03); for aortic dissection, 0.95 (95% CI, 0.61 to 1.49); and for aortic rupture, 0.81 (95% CI, 0.49 to 1.35). There were no significant between-group differences in safety outcomes. CONCLUSIONS: After more than 5 years, the invitation to undergo comprehensive cardiovascular screening did not significantly reduce the incidence of death from any cause among men 65 to 74 years of age. (Funded by the Southern Region of Denmark and others; DANCAVAS ISRCTN Registry number, ISRCTN12157806.).

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Authors: Lindholt, J. S., Søgaard, R., Rasmussen, L. M., Mejldal, A., Lambrechtsen, J., Steffensen, F. H., Frost, L., Egstrup, K., Urbonaviciene, G., Busk, M., & Diederichsen, A. C. P.
Affiliations: University of Southern Denmark (DK)
From the Departments of Cardiac, Thoracic, and Vascular Surgery (J.S.L., R.S.), Clinical Biochemistry and Pharmacology (L.M.R.), and Cardiology (A.C.P.D.), Elite Research Center for Individualized Medicine in Arterial Diseases, and the Open Patient Data Explorative Network (A.M.), Odense University Hospital, Clinical Institute, University of Southern Denmark (R.S.), Odense, the Department of Cardiology, Odense University Hospital, Svendborg (J.L., K.E.), the Department of Cardiology, Lillebaelt Hospital, Vejle (F.H.S., M.B.), and the Department of Cardiology, Diagnostic Center, Regional Hospital Silkeborg, Silkeborg (L.F., G.U.) — all in Denmark.
ORCID: Lindholt, Jes S.
Søgaard, Rikke
Rasmussen, Lars M.
Lambrechtsen, Jess
Steffensen, Flemming H.
Frost, Lars
Egstrup, Kenneth
Busk, Martin
Diederichsen, Axel Cosmus Pyndt
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2022-10-13
Volume: 387
Issue: 15
Pages: 1385-1394
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa2208681
OpenAlex: W4293872316
Semantic Scholar: e45554186343dbbd4336d0fe7a98a8b8783cffbe
Cited by: 182
References: 13
Citations by year: 2026: 34 · 2025: 53 · 2024: 39 · 2023: 42 · 2022: 12
FWCI: 32.23
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.nejmgroup.org/legal/terms-of-use.htm (vor)
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, other-oa)
Funders: Hjerteforeningen
Danish Independent Research Councils
Helsefonden
Odense Universitetshospital
Region of Southern Denmark
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
Keywords: cardiovascular screening, coronary artery calcium score, aortic aneurysm, atrial fibrillation, peripheral arterial disease, hypertension, diabetes mellitus, hypercholesterolemia, all-cause mortality, stroke, myocardial infarction, aortic dissection, aortic rupture
MeSH terms: Aged, Calcium, Cardiovascular Diseases, Denmark, Humans, Male, Mass Screening, Incidence, Cardiac-Gated Imaging Techniques, Peripheral Arterial Disease

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Five-Year Outcomes of the Danish Cardiovascular Screening (DANCAVAS) Trial

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