Cholesterol agonistics

Article Abstract:

The 1996 guidelines from the American College of Physicians on cholesterol screening should not be followed because they limit screening too much, mainly to middle-aged men. The authors of the guidelines reason that if all adults have their cholesterol levels measured, cholesterol-reducing drugs will be over-prescribed by physicians and these drugs may increase non-cardiovascular death rates. However, physicians will probably not over-prescribe such drugs, as they generally tend to under-prescribe them. In addition, lowering cholesterol significantly inhibits plaque formation and probably does not increase mortality from non-cardiovascular causes. Moreover, dietary and exercise interventions, which the authors argue are ineffective, have been effective in lowering cholesterol levels in some people. These guidelines rely too much on clinical trials and epidemiological data and too little on physiological data. Cholesterol screening is inexpensive and should be performed on most adults.

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Guidelines for using serum cholesterol, high-density lipoprotein cholesterol, and triglyceride levels as screening tests for preventing coronary heart disease in adults

Article Abstract:

The American College of Physicians presents its guidelines for cholesterol screening. Initial screening should include a measurement of total cholesterol, but not necessarily of high density lipoproteins or triglycerides. If the total cholesterol level is in near the range associated with risk, it should be retested approximately every five years. Men younger than 35 and women younger than 45 should not have a their cholesterol measured unless they have a family history of lipoprotein disorder or other risks for coronary heart disease. Men with ages from 35 to 65 and women with ages from 45 to 65 should have cholesterol screening. Scientific evidence does not indicate whether or not testing is worthwhile for people between the ages of 65 and 75. People over the age of 75 should not be tested. People with blood vessel disease should have total cholesterol and other lipid levels measured.

Publishing industry, Practice guidelines (Medicine), American College of Physicians

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Deciding about screening

Article Abstract:

The prevalence of a disease should be an important factor in deciding whether to implement a general screening policy. An analysis of the efficacy of screening for ovarian cancer, a rare but fatal disease, concludes that it is the rarity of the disease that prevents large-scale screening from being effective, not the testing itself. Though early intervention can significantly improve the life expectancy of patients with ovarian cancer, the benefits of identifying the disease in its early stages must be weighed against the potential harm some of the screening procedures may cause to the other women who undergo testing. The identification of groups at high risk for developing certain rare diseases would be more beneficial than large-scale screening of the general population.

Diagnosis, Column, Diseases

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