USPSTF: Evidence Lacking for Screening for Lipid Disorders in Patients Aged 20 and Younger

TUESDAY, July 18, 2023 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient for assessing the balance of benefits and harms of screening for lipid disorders in children and adolescents aged 20 years or younger. These findings form the basis of a final recommendation statement published in the July 18 issue of the Journal of the American Medical Association.

Janelle M. Guirguis-Blake, M.D., from the Kaiser Permanente Evidence-based Practice Center in Portland, Oregon, and colleagues reviewed the benefits and harms of screening and treatment of pediatric dyslipidemia due to familial hypercholesterolemia (FH) and multifactorial dyslipidemia. Data were included from 43 studies with 491,516 participants. The researchers found that no randomized clinical trials (RCTs) directly addressed the effectiveness and harms of screening. The prevalence of phenotypically defined FH was 0.2 to 0.4 percent in three U.S. studies, and the prevalence of elevated total cholesterol and of any lipid abnormality was 7.1 to 9.4 percent and 19.2 percent, respectively. Statins were associated with an 81- to 82-mg/dL greater mean reduction in levels of total cholesterol and low-density lipoprotein cholesterol compared with placebo at two years based on 10 RCTs. Statin treatment for FH starting in childhood or adolescence reduced long-term cardiovascular disease risk in observational studies.

Based on these findings, the USPSTF concludes that the current evidence is insufficient for assessing the balance of benefits and harms of lipid disorder screening among asymptomatic children and adolescents aged 20 years or younger (I statement).

"We don't have enough evidence to tell us whether or not screening all children and adolescents for high cholesterol is beneficial," a task force member said in a statement.

Evidence Report

Final Recommendation Statement

Editorial