Impact of a public cholesterol screening program

Article Abstract:

Since 1984, a major recommendation from the National Institutes of Health has been to raise the awareness of adults concerning their blood cholesterol levels. Testing by physicians during office visits rather than public screening was the recommended route by which to achieve this goal, because the impact of public screening was not clear. In spite of this, public screening has proliferated, but the cost and benefits of such programs are still not well studied. Among 3,267 people who chose to have their cholesterol levels screened at a shopping mall, 1,079 were selected for a survey of the impact of such screening. Of 678 responding, 433 had not previously been screened. The results suggest that those who were screened were not likely to benefit from screening, having lower than average or average levels of risk factors for coronary artery disease, such as smoking. Survey respondents tended to remember their cholesterol levels correctly and identify risk associated with these levels correctly. Although respondents with higher levels initially were distressed, no adverse effect on psychological well-being was found one year later, at the time of the survey. Only half of those with elevated risk of cardiovascular disease, indicated by elevated cholesterol levels had sought medical care within a year of screening. The results suggest that public cholesterol screening programs are unlikely to contribute to reducing the amount of illness or death associated with cardiovascular disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cholesterol

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Physician reaction to a local community cholesterol screening program

Article Abstract:

National attention to the role of elevated blood cholesterol in causing coronary heart disease has led to a program of education and mass screening. During a 15-day period in summer of 1987, 11,680 individuals were screened in a cooperative program sponsored by the National Heart Savers Association and the City Health Department of Racine, Wisconsin. The site selected was a local shopping mall in this city of 85,000. Local media were used to promote the program, but physicians were not individually targeted for participation. As a result of the program, 3,069 individuals (26.3 percent) were referred to their private physicians. Three months after the end of the program, questionnaires were sent to the 76 local physicians, of whom 58 responded. Seventy-nine percent of the physicians indicated that they had been aware of the program and at least 40 percent of those had diagnosed at least one case of elevated cholesterol in patients who had been referred. The ultimate goal of this project was to identify individuals at added risk for premature cardiovascular difficulties as a result of their elevated blood cholesterol levels. The results of the community and professional response to this aggressive screening program demonstrate that public health approaches for hypercholesterolemia will only work when done in concert with local health professionals. The results also demonstrate that over 71 percent of the physicians surveyed support such screening efforts.

Testing, Prevention, Coronary heart disease, Hypercholesterolemia

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Recommendations regarding public screening for measuring blood cholesterol

Article Abstract:

Widespread blood cholesterol screening is possible because of new uncomplicated laboratory methods. However, the reliability of test results as well as the education and follow-up of patients who test high are deficient. To improve screening effectiveness, the National Heart, Lung, and Blood Institute recommends the following standards regarding public screening of blood cholesterol: recruitment of screened individuals should be representative of all population groups; testing sites should be widely accessible, with flexible hours and locations; the laboratory equipment must be approved, precise and accurate; proper techniques to obtain blood samples should be followed; in addition to cholesterol values, educational materials must be provided by specifically trained staff; screening in a comfortable, private environment should be available; and the service should be provided at a low cost. Patients having cholesterol levels higher than 200 should be referred for further medical evaluation. Following guidelines for referral appropriate for each different cholesterol level is recommended. Referral follow-up is also suggested.

Standards, Health risk assessment, United States. National Heart, Lung and Blood Institute

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