Impact of a public cholesterol screening program.

Area of Science:

• Cardiovascular Health
• Public Health Interventions
• Health Screening

Background:

• The National Cholesterol Education Program (NCEP) recommends physician case finding for elevated cholesterol.
• Promotional and for-profit public cholesterol screening programs are widespread.
• Effectiveness of public screening programs versus physician-led case finding is debated.

Purpose of the Study:

• To evaluate the outcomes of participants in a mall-based cholesterol screening program.
• To assess the characteristics and follow-up compliance of individuals screened in public settings.
• To determine the contribution of such programs to national coronary heart disease reduction efforts.

Main Methods:

• Survey of participants in a mall-based cholesterol screening program one year post-screening.
• Analysis of participant demographics, prior testing history, cholesterol level recall, and understanding of risks.
• Tracking of follow-up care adherence for individuals with elevated cholesterol levels.

Main Results:

• 64% of screened individuals were unaware of their cholesterol levels prior to the event.
• Newly screened participants were older, more likely female, and were nonsmokers, potentially representing a lower-benefit group.
• Recall of cholesterol levels and understanding of risk were high, but only 53.7% of those advised to seek follow-up did so.
• Follow-up rates were higher (68%) for those with very high cholesterol levels ( > 6.2 mmol/L).

Conclusions:

• Public cholesterol screening programs often reach individuals who may not benefit the most or have already been tested.
• Compliance with recommended follow-up care after public screening is suboptimal.
• Current public cholesterol screening models are unlikely to significantly advance national goals for coronary heart disease reduction.