The psychological and social implications of serum cholesterol screening

Mass screening of the population to detect cases of lipid derangement which could be at a higher risk for cardiovascular disease is not without its complications and risks. These have been demonstrated primarily in older screening programmes, e.g. for breast cancer or hypertension. They include the difficulties created by inconstant and variable findings, the risk of profound anxiety where findings are positive, the temptation to handle any abnormal finding by prolonged medicinal treatment, but also the neglect of healthy lifestyles where a negative finding suggests a "clean bill of health" or a drug is thought to guarantee normality. Screening and treatment programmes created under technological, scientific or commercial pressures can seriously derange the allocation of health care resources. Such programmes should be instituted only for sound medical reasons and with adequate planning for patient guidance, follow-up and risk evaluation.