Universal Screening is Still Not Recommended But May Be Beneficial

A targeted approach to cholesterol screening for children recommends screening children with a family history of premature cardiovascular disease or high blood concentrations of cholesterol; it also recommends screening children for whom the family history is unknown or who have other risk factors such as obesity, hypertension and diabetes. Universal screening is still not recommended, although in my opinion, it may be beneficial given the epidemic of obesity and other problems. The assumption of a targeted approach is that the family history will provide additional information regarding genetic predisposition and environmental factors that may increase risk. Family history may not be known, or may be incomplete; adults may or may not know their own cholesterol and understand the significance of the abnormal results, if any. Studies of this targeted approach have found that nearly half of children and teens have had cholesterol levels measured on the basis of family history. Therefore, with half being unknown, the incidence of obesity increasing, the percentage of children who would qualify for having their cholesterol measured will be increased. It is estimated that 30-60% of children with high cholesterol levels will be missed by the targeted strategy.