In an updated statement, the U.S. Preventive Services Task Force (USPSTF) finds insufficient evidence to assess the balance of benefits and harms of routine screening for any lipid disorders, including familial hypercholesterolemia (FH), in children and adolescents 20 years of age or younger. This conclusion of insufficient evidence is the same as a 2016 assessment of this topic.
A current evidence review accompanies the recommendation statement. “No direct evidence on the benefits or harms of pediatric lipid screening was identified,” the authors conclude. “While multifactorial dyslipidemia is common, no evidence was found that treatment is effective for this condition. In contrast, FH is relatively rare; evidence shows that statins reduce lipid levels in children with FH, and observational studies suggest that such treatment has long-term benefit for this condition.”
Editorial: “The current I statement [for insufficient evidence] from the USPSTF pushes the possibility of a systematic national childhood lipid screening program into the future,” editorialists write. “However, we believe that the evidence supporting specific screening for and treatment of FH in childhood is growing, and a universal screening approach to reduce the burden of premature atherosclerotic cardiovascular disease among persons with FH will likely be adopted in the future. In the meantime, clinicians can rely on existing guidelines and decide together with pediatric patients and their families if and when to screen for lipid disorders in childhood.”