Abstract
Background
In 2011, a US expert panel recommended universal cholesterol screening for children
ages 9 to 11 years. Controversy exists over this recommendation, especially because
the most recent systematic review on universal childhood screening was inconclusive.
Objectives
To conduct an updated systematic review on universal cholesterol screening in childhood
and effect on health outcomes, clinical management, screening acceptability, and healthcare
costs.
Data Sources
We searched MedLine, EMBASE, Psychinfo, and the Cochrane Registry of Controlled Trials
from October 2005 to January 2016. We added new studies identified to those from the
previous systematic review (1966–September 2005).
Study Eligibility, Participants, and Interventions
We included controlled trials, pre-post, cohort, survey, and qualitative studies of
universal cholesterol screening in children ages 0 to 18 years.
Study Appraisal and Synthesis Methods
Two independent reviewers assessed abstracts and full-text studies, extracted data,
and ranked quality. Cost data were inflation-adjusted to 2015 dollars.
Results
Nine new studies met inclusion criteria, taking the total number of relevant studies
to 21. Screening was associated with no change in cholesterol in 1 of 1 study on health
outcomes. A positive screen for dyslipidemia was associated with diet and/or exercise
changes in 29% to 92% of families in 4 of 4 studies. Adherence with new guidelines
for universal screening was low (16%–18%) in 3 of 3 studies. Costs per case of familial
hypercholesterolemia detected were $12,500 to $20,300.
Limitations
Included studies were heterogeneous in outcomes.
Conclusions and Implications of Key Findings
Universal cholesterol screening might have small, positive effects on lifestyle change,
but the effect on health remains understudied.
Keywords
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Article Info
Publication History
Published online: June 21, 2016
Accepted:
June 15,
2016
Received:
November 9,
2014
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
Copyright © 2016 by Academic Pediatric Association
