The case against childhood cholesterol screening

Article Abstract:

In contrast to the opinion offered by many medical authorities that children should be screened for high cholesterol levels, the viewpoint is advanced that fewer, rather than more, children should be screened in that fashion. A review of published research results is presented to support the authors' viewpoint. Studies have shown that childhood cholesterol levels are poor predictors of levels in young adulthood, and poorer predictors of levels later in adulthood. These levels, in turn, are not perfect predictors of coronary heart disease (CHD). A table is constructed that shows the cumulative risk of premature death from CHD based upon blood cholesterol levels of boys and men. All risks are small, and more than half the boys with risk levels in the highest quintile will not be in the highest quintile as adults. Children at risk for CHD cannot be identified by cholesterol screening. Nor is it known that treatments aimed at reducing risk are more effective if started in childhood than if begun in adulthood. This appears to be true for diet, since dietary fat reductions are associated with reductions in cholesterol levels of 5 percent, or less. Moreover, no evidence exists that lowering cholesterol levels in childhood is more beneficial than lowering them in adulthood. Finally, results from cholesterol screening can lead to programs that are actually harmful to children, such as strict adherence to low-fat diets which do not provide adequate nutrition for growth. Results from one series of studies showed that people who lowered their cholesterol via diet or drugs were 76 percent more likely to die in accidents, violence, or through suicide than control subjects. Psychological factors can also affect children on unusual diets adversely. Can a parent in good faith explain to a child that he cannot eat a hot dog because he will then be 1 percent less likely to die in the next 60 years of a heart attack? Cholesterol measurement should not be foisted upon children before the age of 20, children who have better things to do - such as ''growth, surviving adolescence, and enjoying ice cream''. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Risk factors, Children, Demographic aspects, Coronary heart disease, Hypercholesterolemia

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Should we be measuring blood cholesterol levels in young adults?

Article Abstract:

Screening and treating young adults for high blood cholesterol levels is not cost-effective and may cause more harm than good. While the benefits of lowering blood cholesterol in middle-aged men and women who have a high risk of coronary heart disease (CHD) are clear, the benefits in men under age 35 and women under age 45 with low short-term risk of CHD are in dispute. A cost-benefit analysis of treating young adults with high blood cholesterol but otherwise at low risk of CHD estimated that the cost of intervention would be $1 million to $10 million per year of prolonged life. This is far greater than the cost of other early interventions such as smoking-cessation programs. Furthermore, recent studies on middle-aged men who were treated for high blood cholesterol found that while their risk for CHD dropped, their increased risk of death from other causes was significant enough to outweigh the benefits of treatment. Among young adults whose risk of CHD is already low, the adverse effects of intervention may be even greater.

Health aspects, Young adults

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Childhood cholesterol screening: contraindicated

Article Abstract:

The costs of cholesterol screening in children -- even those with a family history of coronary heart disease or high blood cholesterol -- may outweigh the benefits. Studies of the use of cholesterol-lowering drugs in adults with high blood cholesterol have found an increase in deaths from diseases other than heart disease. For this reason, it may be premature to recommend cholesterol screening in children.

Usage, Medical screening, Health screening, Cholesterol

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