Document Detail

Position statement: cholesterol screening in children is not indicated, even with positive family history.
MedLine Citation:
PMID:  1619193     Owner:  NLM     Status:  MEDLINE    
The same reasons for the policy of rejecting universal blood cholesterol screening in all children also lead us to reject selective screening in those with a family history of premature CHD or high blood cholesterol. It is probably true that this large group--roughly 25% of all children, 12 million in the United States and many tens of millions worldwide--is at somewhat higher risk than the other 75% of children of eventually dying of CHD many decades later. But the small size and remoteness of any benefit achieved by cholesterol intervention is illustrated by the projection that we would need to treat 300 girls in the top cholesterol quintile, and treat them effectively for 50-60 years, in order to defer just one premature CHD death before age 65. The benefits of cholesterol screening and treatment in children are not only very small and remote, they are also uncertain; we have no firm evidence that they exist. The benefits are not needed, given the clinical trial evidence that most of the risk associated with high blood cholesterol among adults is reversible, even when intervention is not begun until middle age. The harmful effects of cholesterol screening and treatment are more firmly established than the benefits, and some are very serious. Such a program would be expensive orders of magnitude from conventional criteria for cost effectiveness. It would cause malnutrition in some children, and have the adverse consequences of labelling.(ABSTRACT TRUNCATED AT 250 WORDS)
S B Hulley; T B Newman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Nutrition     Volume:  11 Suppl     ISSN:  0731-5724     ISO Abbreviation:  J Am Coll Nutr     Publication Date:  1992 Jun 
Date Detail:
Created Date:  1992-08-05     Completed Date:  1992-08-05     Revised Date:  2008-06-23    
Medline Journal Info:
Nlm Unique ID:  8215879     Medline TA:  J Am Coll Nutr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  20S-22S     Citation Subset:  IM    
Department of Epidemiology, UC Medical Center, San Francisco 94143.
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MeSH Terms
Cholesterol / blood*
Coronary Disease / etiology,  prevention & control*
Hypercholesterolemia / complications,  diagnosis*,  therapy
Mass Screening*
Neoplasms / etiology
Nutrition Disorders / etiology
Risk Factors
Wounds and Injuries / etiology
Reg. No./Substance:

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