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Childhood screening for high cholesterol is feasible

Analysis of a study published in a science journal   |   By Dr Philippa Brice   |   Published 11 August 2011
Study: Child-Parent Screening for Familial Hypercholesterolemia
By: Wald D.S. et al. (7 authors total)
In: Journal of Pediatrics
Link: http://dx.doi.org/10.1016/j.jpeds.2011.06.006
What this study set out to do:

Examine the feasibility of screening children and their parents for familial hypercholesterolaemia (FH) at the same time as performing routine childhood immunizations. 

How they went about it:

200 children were tested with parental permission, via a heel-prick blood sample for cholesterol testing taken at the same time as immunization. Parents were contacted by phone to report the results of screening and ask about their experiences. 

Outcome:

No cases of FH were detected. 98% of parents said they were happy with the screening and 94% would have a second child screened if the opportunity arose. Based on normal population levels of FH, the estimated cost of this approach was £3500 per case detected. 

Conclusion:

FH screening in children is feasible and acceptable, with immunization clinics offering an ideal opportunity as screening gives the most accurate results in children aged 1-2. Costs are likely to be around a tenth that of the cost of antenatal screening for Down’s syndrome or cystic fibrosis. A larger study is needed to determine the appropriate cholesterol cutoff point for diagnosis of FH; five of the 200 children would have met a slightly lower cutoff. 

Our view:

Early detection of this very common form of inherited disease could deliver great improvements in health for affected children; this very practical approach could also prove effective in identifying further cases among family members. The paper is a valid proof-of-concept, but larger pilot studies will indeed be required to take it further. 

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