Cholesterol screening in the adolescent

Screening and Treatment for Lipid Disorders in Children and Adolescents: Systematic Evidence Review for the US Preventive Services Task Force

“…64 Regardless of the precise definition, using positive family-history information to trigger lipid testing misses substantial numbers of children with elevated lipid levels, ranging from 17% to 90% overall and 30% to 60% in most studies. 32, 63,64,67,69,71,[74][75][76] The proportion of children and adolescents who qualify for screening on the basis of family history is generally between 25% and 55% depending on the sensitivity of the specific familyhistory question. *…”

Universal Cholesterol Screening in Childhood: A Systematic Review

“…21,36,39 Clinic-based screening generally had higher participation rates than school-based screening. The impact of family history on participation rates was mixed: one study found higher participation in children with family history of high cholesterol (p<0.001) 24 , one no difference 33 , and one study a lower participation rate (45% of non-participants had positive family history vs. 35% of participants, p<0.05). 30…”

“…21,31,33,[36][37][38][39] Two additional studies conducted follow-up testing, but did not report attendance. 29,32 Twenty to 80% children did not complete evaluation of lipid levels (Table 3); the most recent study (2006) reported 55% attendance at follow-up.…”

“…Thirteen studies addressed screening in children aged 12 years and younger 19,20,26,[28][29][30][31][32] , four studies addressed adolescents [33][34][35][36] , and four studies addressed both young children and adolescents. 21,[37][38][39] Seventeen studies were from the United States, two from the UK 19,35 , one from Slovenia 26 , and one from Denmark.…”

Continuing Education Forum. Screening and Treating Children at Risk for Coronary Heart Disease

“…"Children of parents with a combination of CHD and hyperlipidemia are at increased risk of developing early atherosclerosis and need lipid estimation screening" (p. 289). Gagliano, Emans, and Woods (1993) suggest that adolescents be screened rather than children to avoid testing during the years of significant cholesterol level fluctuations and to do so when a change in diet would have less impact on the growing child. There are multiple reasons for the controversy regarding who should be screened and when.…”