Regional cholesterol screening: problems and potentials

Mass cholesterol level screening was carried out in 3,288 individuals. Over a wide range of ages, moderate or high risk values were found in 16%. Follow-up of those with abnormal cholesterol levels revealed that a low percentage visited their family physicians. Moreover, successful responses to treatment were identified in a very small number. The cost of lowering an elevated serum cholesterol level identified in this manner was approximately $800. Problems and potentials of this approach are discussed. Interest in serum cholesterol level control and understanding of its importance have greatly increased. Patients and physicians have become more well informed as a result of the Lipid Research Clinics-Coronary Primary Prevention Trial (LRC-CPPT) and recent guidelines proposed by the National Heart Lung and Blood Institute (NHLBI). As a result of these reports, it is now recognized that lowering an elevated cholesterol by 1% causes a 2% reduction in mortality from coronary artery occlusive disease. Moreover, it is now conceded that normal levels are much less than had been thought previously and it is recommended that all adults receive treatment to maintain a serum cholesterol less than 200 mg/dl. We were recently invited to present an exhibit in the high technology area of the Kentucky State Fair. This provided an opportunity to develop and test the mass screening process, collect data, and to evaluate the cost-effectiveness of such screening processes.