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

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. 

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. 

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. 

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.